Importance of anticoagulant proteins in chronic liver diseases.
OBJECTIVE
This study was conducted to elucidate the importance of anticoagulant proteins in chronic liver disease and their possible role as markers in determining the severity of the liver disease.


METHODS
This study was conducted on 35 patients with cirrhosis, 15 patients with chronic active hepatitis and 10 healthy controls. Coagulation inhibitor proteins such as protein C, protein S and antithrombin, as well as D-dimer level and thrombin time, which reflect fibrin degradation products, were measured. Cirrhotic patients were categorized as Child A, B and C and chronic active hepatitis patients as mild or moderate activity according to the modified Knodell histopathologic classification. The parameters were compared between patient groups and healthy controls.


RESULTS
In comparison with controls, the cirrhotics had significantly decreased protein C, protein S, antithrombin levels and increased D-dimer levels. The Child B and Child C patients differed significantly with respect to protein C and antithrombin levels only. In the chronic active hepatitis patients, protein S, protein C and fibrinogen were within normal limits, whereas antithrombin was low.


CONCLUSIONS
In chronic active hepatitis, the antithrombin level may be used as an early marker of hepatocellular damage. In cirrhotics, protein C and antithrombin may be useful for assessment of hepatocellular damage, whereas D-dimer may be important for the transition to decompensation.
Gürsoy
Sebnem
S
Department of Gastroenterology, School of Medicine, Erciyes University, Kayseri, Turkey. sgursoy@erciyes.edu.tr
Başkol
Mevlüt
M
Torun
Edip
E
Yurci
Alper
A
Soyuer
Işin
I
Eser
Bülent
B
Güven
Kadri
K
Ozbakir
Omer
O
Yücesoy
Mehmet
M
D000328:Adult; D000368:Aged; D000991:Antithrombins / Q000378:metabolism; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D019774:Blood Coagulation Factor Inhibitors / Q000378:metabolism*; D001780:Blood Coagulation Tests; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005340:Fibrinogen / Q000378:metabolism; D019694:Hepatitis B, Chronic / Q000097:blood* / Q000150:complications / Q000473:pathology; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000150:complications / Q000473:pathology; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000209:etiology / Q000473:pathology; D008875:Middle Aged; D011486:Protein C / Q000378:metabolism; D017293:Protein S / Q000378:metabolism; D012709:Serum Albumin / Q000378:metabolism; D012720:Severity of Illness Index
D000991:Antithrombins; D015415:Biomarkers; D019774:Blood Coagulation Factor Inhibitors; D005338:Fibrin Fibrinogen Degradation Products; D011486:Protein C; D017293:Protein S; D012709:Serum Albumin; C036309:fibrin fragment D; D005340:Fibrinogen; D001663:Bilirubin