Plasma activity of thrombin activatable fibrinolysis inhibitor in Crimean-Congo hemorrhagic fever.
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.
Sonmez
Mehmet
M
Department of Haematology, Karadeniz Technical University, School of Medicine, Trabzon 61080, Turkey. mesonmez@yahoo.com
Aydin
Kemalettin
K
Durmus
Ahmet
A
Sucu
Nurgul
N
Yilmaz
Mustafa
M
Akdogan
Elif
E
Koksal
Iftihar
I
Ovali
Ercument
E
Omay
Serdar Bedii
SB
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
D025901:Carboxypeptidase B2