Development of antithrombin antibodies following surgery in patients with prosthetic cardiac valves.
Although antibody inhibitors directed against blood coagulation factors are well known, antibody inhibitors directed against thrombin are rare. We describe three postsurgical patients with prosthetic cardiac valves who developed serum autoantibodies reactive with human and bovine thrombin, as demonstrated by coagulation studies and immunoblotting. Despite marked prolongation of the thrombin time in these patients, the inhibitors were not associated with significant clinical bleeding. The mechanism of antithrombin autoantibody formation following surgery in patients with prosthetic cardiac valves remains to be determined.
Stricker
R B
RB
Department of Laboratory Medicine, University of California, San Francisco 94143.
Lane
P K
PK
Leffert
J D
JD
Rodgers
G M
GM
Shuman
M A
MA
Corash
L
L
D000328:Adult; D000991:Antithrombins / Q000276:immunology*; D001323:Autoantibodies / Q000096:biosynthesis* / Q000302:isolation & purification; D001666:Binding Sites, Antibody; D001780:Blood Coagulation Tests; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D015151:Immunoblotting; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D011183:Postoperative Complications / Q000097:blood; D011517:Prothrombin Time
D000991:Antithrombins; D001323:Autoantibodies