Plasma protein C levels in disseminated intravascular coagulation (DIC) and thrombotic thrombocytopenic purpura (TTP)

Protein C was measured by means of an enzyme-linked immunosorbent assay (ELISA) in plasmas from 46 normal subjects, 34 patients with disseminated intravascular coagulation (DIC) and 4 patients with thrombotic thrombocytopenic purpura (TTP). Normal range in the assay was 73. 5-155. 0 % (95% confidence limits) of a normal pooled plasma. In patients with DIC, plasma protein C concentrations were significantly decreased, with a geometric mean value of 43.1 %. The protein C concentration was positively correlated with plasma prothrombin, antithrombin III and serum pseudocholinesterase, and was negatively correlated with von Willebrand factor antigen (vWF: Ag) and vWF: Ag/f actor VIII ratio. These findings suggest that low protein C concentrations in DIC mean a consumption of protein C probably due to its activation by thrombin and/or impaired liver synthetic function. In patients with TTP, plasma protein C levels were normal with a geometric mean value of 125. 3 %, indicating that the pathophysiology of TTP is quite different from that of DIC.

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