Microvesicle-associated tissue factor and Trousseau's syndrome.
BACKGROUND
Trousseau's syndrome is a prothrombotic state associated with malignancy that is poorly understood pathophysiologically.


RESULTS
Here we report studies on the blood of a 55-year-old man with giant-cell lung carcinoma who developed a severe form of Trousseau's syndrome. His clinical course was dominated by an extremely hypercoagulable state. Despite receiving potent antithrombotic therapy, he suffered eleven major arterial and venous thrombotic events over a 5 month period. We examined the patient's blood for tissue factor (TF), the major initiator of coagulation, and found its concentration in his plasma to be forty-one-fold higher than the mean concentration derived from testing of 16 normal individuals.


CONCLUSIONS
Almost all of the TF in the patient's plasma was associated with cell-derived microvesicles, likely shed by the cancer cells.
Del Conde
I
I
Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Bharwani
L D
LD
Dietzen
D J
DJ
Pendurthi
U
U
Thiagarajan
P
P
López
J A
JA
D001777:Blood Coagulation; D018286:Carcinoma, Giant Cell / Q000097:blood* / Q000150:complications / Q000473:pathology; D022162:Cytoplasmic Vesicles / Q000378:metabolism*; D004797:Enzyme-Linked Immunosorbent Assay; D015942:Factor VIIa / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D008074:Lipoproteins / Q000097:blood; D008175:Lung Neoplasms / Q000097:blood* / Q000150:complications / Q000473:pathology; D008198:Lymph Nodes / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D013577:Syndrome; D013925:Thromboplastin / Q000378:metabolism*; D013927:Thrombosis / Q000097:blood* / Q000209:etiology
D008074:Lipoproteins; C051928:lipoprotein-associated coagulation inhibitor; D013925:Thromboplastin; D015942:Factor VIIa