Kallikrein-kinin system activation in streptococcal toxic shock syndrome.
A retrospective analysis of 7 patients with streptococcal toxic shock revealed isolated prolongation of the activated partial thromboplastin time, which returned to normal during recovery. Levels of factor XII were reduced in 2 patients who had single factor assays performed, consistent with activation of the kallikrein-kinin system. We speculate that bradykinin release following activation of the kallikrein-kinin system in streptococcal toxic shock may underlie the features of pain, capillary leaking, and severe hypotension characteristic of this syndrome.
Sriskandan
S
S
Department of Infectious Diseases, Imperial College School of Medicine, Hammersmith Hospital, London W12 0NN, United Kingdom. s.sriskandan@ic.ac.uk
Cohen
J
J
D001920:Bradykinin / Q000378:metabolism; D006801:Humans; D007610:Kallikreins / Q000378:metabolism*; D007705:Kinins / Q000378:metabolism*; D010314:Partial Thromboplastin Time; D011517:Prothrombin Time; D012189:Retrospective Studies; D012772:Shock, Septic / Q000382:microbiology / Q000503:physiopathology*; D013290:Streptococcal Infections / Q000382:microbiology / Q000503:physiopathology*; D013297:Streptococcus pyogenes
D007705:Kinins; D007610:Kallikreins; D001920:Bradykinin