Serial studies of protein C and its plasma inhibitor in patients with disseminated intravascular coagulation.
This study was undertaken to determine the levels of protein C antigen and activity and protein C inhibitor in sequential plasma samples of disseminated intravascular coagulation (DIC) patients. Our normal range for both protein C antigen and activity is 70 to 130 U/dL, and protein C inhibitor is 65 to 135 U/dL. A decreased level of protein C activity was found in 96% of the plasma samples from individuals with DIC; the protein C antigen was decreased in 73%. The inhibitor of protein C was decreased in all samples. Analysis of serial samples from patients with DIC reveals that protein C activity and antigen and protein C inhibitor decrease progressively during the initial stages of DIC and remain at a low level for 24 to 48 hours before gradually returning toward normal in nonfatal cases. The protein C activity decreases in parallel with protein C inhibitor and is lower than protein C antigen. In a fatal case of DIC, protein C activity and protein C inhibitor rapidly decreased to undetectable levels; however, protein C antigen was gradually decreasing but still detectable at time of death. In DIC, a discrepancy initially occurs between the activity and antigen of protein C, suggesting a complex with the inhibitor or other inactive forms of protein C. Protein C appears to play a major role in the control of DIC.
D001779:Blood Coagulation Factors / Q000032:analysis*; D002648:Child; D004211:Disseminated Intravascular Coagulation / Q000201:enzymology*; D005165:Factor V / Q000032:analysis; D005169:Factor VIII / Q000032:analysis; D005260:Female; D006023:Glycoproteins / Q000037:antagonists & inhibitors / Q000097:blood*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000097:blood; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000097:blood; D011486:Protein C; D018805:Sepsis / Q000097:blood; D013997:Time Factors
D001779:Blood Coagulation Factors; D006023:Glycoproteins; D011486:Protein C; D005165:Factor V; D005169:Factor VIII