Analyses of factor XII, prekallikrein and kallikrein inhibitory capacity in patients with laboratory signs of DIC.
We investigated 22 severely ill patients (21 surgical, 1 medical) at the intensive care unit. Analyses of platelet count, Normotest, antithrombin III, FDP and fibrinogen were used to divide the patients into three diagnostic groups: DIC (3 positive tests), suspected DIC (2 positive tests) and No DIC. Using these criteria 9, 8 and 5 patients were referred to these diagnostic groups, respectively. Factor XII and prekallikrein did not differ significantly between the three diagnostic groups. On the other hand the capacity of the patient plasma to inhibit kallikrein was significantly lower in the DIC group. The decrease of kallikrein inhibitory capacity was correlated to the decrease of antithrombin III and alpha 2-antiplasmin. Out of the 22 patients in the study 8 patients died, 5 of these were in the DIC group. Non-surviving patients showed lower values of the protease inhibitors than survivors. It is concluded that in this type of patients and with the laboratory methods used contact phase factors do not seem to be affected in DIC. Analyses of the kallikrein inhibitory capacity, antithrombin and alpha 2-antiplasmin on the other hand seem to be of interest to measure, though the decrease of these inhibitors could be due to consumption as well as to reduced protein synthesis. Further studies are needed to prove the prognostic value of assaying these protease inhibitors.
D003422:Critical Care; D004211:Disseminated Intravascular Coagulation / Q000097:blood* / Q000209:etiology / Q000503:physiopathology; D005174:Factor XII / Q000032:analysis*; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D007610:Kallikreins / Q000032:analysis* / Q000037:antagonists & inhibitors*; D010976:Platelet Count; D011288:Prekallikrein / Q000032:analysis*
D005174:Factor XII; D005340:Fibrinogen; D011288:Prekallikrein; D007610:Kallikreins