title: Plasma activity of thrombin activatable fibrinolysis inhibitor in Crimean-Congo hemorrhagic fever.
abstract: OBJECTIVE
  Crimean-Congo hemorrhagic fever (CCHF) is a potentially fatal viral infection. The exact mechanism for hemorrhage remains unknown. Thrombin activatable fibrinolysis inhibitor (TAFI) is a plasma procarboxypeptidase B-like proenzyme and synthesized in the liver, down-regulating fibrinolysis. In this study, we measured the TAFI activity in plasma of patients with CCHF to examine the relationship between hemorrhage and the pathogenesis of CCHF.
  
  
  METHODS
  Twenty-one patients and similar number of controls were included in the study. The diagnosis of CCHF was confirmed through detection of IgM by ELISA and/or PCR. TAFI activity was measured in plasma samples.
  
  
  RESULTS
  TAFI activity in CCHF patient group was mean 7.2+/-2.3 microg/ml (range: 0.95-10.31 microg/ml) and in the control group was mean 11.7+/-4.1 microg/ml (range: 3.07-23.9 microg/ml). There was a significant decrease of TAFI activity in CCHF patients when compared to controls. A positive correlation between CRP, PT, INR, serum albumin and TAFI activity levels were found. We suggest that the decrease of TAFI activity may be due to liver dysfunction during viral active disease state.
  
  
  CONCLUSIONS
  Low TAFI activity may be an attributable factor, leading to imbalance in fibrinolysis, resulting in bleeding complications in CCHF.
authors.affiliation: Department of Haematology, Karadeniz Technical University, School of Medicine, Trabzon 61080, Turkey. mesonmez@yahoo.com
authors.forename: Mehmet
authors.initials: M
authors.lastname: Sonmez
authors.forename: Kemalettin
authors.initials: K
authors.lastname: Aydin
authors.forename: Ahmet
authors.initials: A
authors.lastname: Durmus
authors.forename: Nurgul
authors.initials: N
authors.lastname: Sucu
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yilmaz
authors.forename: Elif
authors.initials: E
authors.lastname: Akdogan
authors.forename: Iftihar
authors.initials: I
authors.lastname: Koksal
authors.forename: Ercument
authors.initials: E
authors.lastname: Ovali
authors.forename: Serdar Bedii
authors.initials: SB
authors.lastname: Omay
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D025901:Carboxypeptidase B2 / Q000096:biosynthesis / Q000097:blood* / Q000378:metabolism; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006479:Hemorrhagic Fever, Crimean / Q000097:blood* / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D019934:International Normalized Ratio; D008099:Liver / Q000201:enzymology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011517:Prothrombin Time
chemical_list: D025901:Carboxypeptidase B2