Changes in Plasma Levels of Prothrombin Fragment F1+2 in Cases of Disseminated Intravascular Coagulation

1993 ◽  
Vol 89 (1) ◽  
pp. 22-25 ◽  
Author(s):  
Hidesaku Asakura ◽  
Yoshimune Shiratori ◽  
Hiroshi Jokaji ◽  
Masanori Saito ◽  
Chika Uotani ◽  
...  
1991 ◽  
Vol 38 (4) ◽  
pp. 281-287 ◽  
Author(s):  
Hidesaku Asakura ◽  
Hiroshi Jokaji ◽  
Masanori Saito ◽  
Chika Uotani ◽  
Ichiro Kumabashiri ◽  
...  

1987 ◽  
Author(s):  
G Fiori ◽  
G Mombelli ◽  
A Haeberli ◽  
P W Straub

To evaluate the hypothesis of disseminated intravascular coagulation (DIC) in liver cirrhosis (LC), we measured the plasma levels of fibrincpeptide A (FPA) and of fibrinogen-fibrin degradation fragment E (FgE) in 58 patients with LC, and compared the results with those measured in 32 healthy subjects as well as in 42 patients with ongoing fibrin formation and lysis related to acute thromboembolism (TE, n = 33) and overt DIC (n = 9).Results: Mean plasma FPA in LC was 2.4 ng/ml compared to 1.8 ng/ ml in normals (p < 0.05) and 12.2 ng/ml in patients with TE or DIC (p < 0.0001). Mean plasma FgE in LC was 108 ng/ml compared to 31.2 ng/ml in normals (p < 0.0001) and to 616 ng/ml in patients with TE or DIC (p < 0.0001). 15 patients with LC (26%) had hypo-fibrinogenemia (fibrinogen< 1.7 g/L). Among these patients, plasma FPA and FgE were 2.3 and 134 ng/ml, as compared to 22.1 and 1310 ng/ml in patients with hypofibrinogenemia related to DIC (p < 0.0001). Intravenous heparin (60 IU/kg) resulted in a prompt decrease of plasma FPA in 14 patients with TE or DIC from 11.8 to 4.3 ng/ml (p < 0.005), but did not significantly change the FPA level in 15 patients with LC as well as in the healthy subjects. Discussion: The present data indicate that thrombin mediated proteolysis of fibrinogen is only marginally increased in LC regardless of whether hypofibrinogenemia is present or not. The data are strongly against the hypothesis of DIC as a frequent and quantitatively important complication of LC and substantiate the conclusion that a “oonsunption coagulopathy” is not a major determinant of impaired hemostasis in liver cirrhosis.


2003 ◽  
Vol 9 (3) ◽  
pp. 233-240 ◽  
Author(s):  
Hideo Wada ◽  
Tomohiro Sase ◽  
Takeshi Matsumoto ◽  
Fumihiko Kushiya ◽  
Miho Sakakura ◽  
...  

Plasma levels of soluble fibrin (SF) were measured in 1184 patients with disseminated intravascular coagulation (DIC) according to Japanese Ministry of Health and Welfare (JMHW) criteria. The usefulness of SF for the diagnosis of DIC was compared with other hemostatic molecular markers. Most hemostatic markers were significantly increased in patients with DIC than in those without DIC. Plasma levels of fibrin and fibrinogen degradation products, thrombin-antihtrombin complex, plasmin-plasmin inhibitor complex, D-dimer, thrombomodulin, and SF levels were also significantly higher in those with pre-DIC than in those without DIC. In classification of overt DIC by International Society of Thrombosis and Haemostasis (ISTH) criteria, most hemostatic markers were significantly increased in patients with overt DIC than in those without overt DIC. Plasma levels of SF 'in patients with DIC were significantly higher than those in patients with pre-DIC, which were significantly higher than in those without DIC. Plasma levels of SF were also significantly higher in patients with overt DIC than in those with non-overt DIC. The correlation between plasma SF levels and DIC score according to JMHW criteria or ISTH criteria was good. Receiver operating characteristic analysis shows that SF was the best marker for the diagnosis of DIC or overt DIC. These findings suggest that plasma SF might be useful marker for the diagnosis of DIC or overt DIC.


Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2142-2142
Author(s):  
Hideo Wada ◽  
Tsutomu Nobori ◽  
Shingo Yamada ◽  
Ikuro Maruyama

Abstract High Mobility Group Box chromosomal protein 1 (HMGB1) is a nuclear DNA-binding protein acting as a proinflammatory cytokine when released in the extracellular space from necrotic cells, activated macrophages and dendritic cells. HMGB1 acts on a specific receptor, RAGE (receptor for advanced glycation end-products), and induces prolonged inflammation, organ failure, septicaemia and death. The aim of the study was to determine the diagnostic value of plasma HMGB1 concentration and its role in the development of organ failure in patients with disseminated intravascular coagulation (DIC). Plasma HMGB-1 levels were measured in patients with suspected DIC by ELISA and their relationships with DIC, organ failure and clinical outcome were determined. The study group included 201 patients suspected of having DIC (79 females and 122 males, age; 52.1±16.5 years, mean±SD). The study group represented all such patients admitted to the Second Department of Internal Medicine and Intensive Care Unit (ICU) of Mie University Hospital between January 1, 2002 and December 31, 2003. The underlying diseases were infectious diseases (n=40), hematopoietic diseases (n=58), solid cancers (n=16), trauma (n=21), aneurysm (n=12), autoimmune diseases (n=8), liver diseases (n=7), post-operation (n=32) and other diseases (n=7). Results: Plasma HMGB1 was below the detection limit in normal subjects, but moderately elevated in patients with infectious diseases (4.54 ± 8.18 ng/ml, mean±SD), malignancies (2.15 ± 5.34 ng/ml), and traumas (6.47 ± 13.13 ng/ml). DIC was associated with significantly high plasma HMGB1 (14.05 ± 12.56 ng/ml) in these patients. The highest HMGBI levels were in patients with organ failure (8.29 ± 10.99 ng/ml) and non-survivors (16.58 ± 11.01 ng/ml). HMGB1 plasma levels correlated with the DIC score and sepsis-related organ failure assessment (SOFA) score. Plasma levels of HMGB1 were significantly higher in patients with PAI-I of >50 ng/ml (3.66 ± 6.36 ng/ml) than in those with PAI-I <50 ng/ml (1.38 ± 2.97 ng/ml) (p< 0.05) but there was no significant difference in HMGB1 levels between patients with TNF-a of >1.5 (3.04 ± 5,56 ng/ml) and those with less than 1.5 pg/ml (2.44 ± 5.36 ng/ml). Our data suggest that HMGB-1 is a potentially suitable prognostic marker of OF or DIC.


1995 ◽  
Vol 74 (03) ◽  
pp. 848-852 ◽  
Author(s):  
Hideo Wada ◽  
Yoshihiro Wakita ◽  
Tutomu Nakase ◽  
Minori Shimura ◽  
Katsuyo Hiyoyama ◽  
...  

SummaryWe examined 395 patients with disseminated intravascular coagulation (DIC) divided into two groups: non-leukemic and leukemic. In 58% of the patients as a whole, treatment of DIC resulted in complete or partial remission, while exacerbation and death occurred in 31%. The efficacy of DIC treatment in the non-leukemic group was less than that in the leukemic group, indicating that the outcome of DIC depended, in part, on the underlying disease. We examined hemostatic indicators in relation to DIC score: prothrombin time (PT) ratio, FDP, platelet count, and fibrinogen levels were found to be important indicators for the diagnosis of DIC, but not for Pre-DIC. Plasma levels of fibrin-D-dimer, thrombin-antithrombin complex (TAT), and plasmin- plasmin inhibitor complex (PPIC) were significantly increased in pre-DIC. The efficacy of treatment in relation to the DIC score when the treatment was begun showed that greater efficacy was achieved in pre-DIC than in DIC patients. The outcome was poorer with increasing DIC score, suggesting that early diagnosis and early treatment are important. On examining the relationship between outcome and hemostatic indicators, we found that the PT ratio and the levels of antithrombin, plasminogen, PPIC, the PPIC/TAT ratio, and thrombomodulin were related to outcome, suggesting that very high consumption of blood coagulation factors, liver dysfunction, hypofibrinolysis, or organ failure caused a poor outcome. Although the outcome in DIC patients may not depend substantially on plasma levels of TAT and fibrin-D- dimer, we can use these indicators to treat DIC patients at an early stage.


Author(s):  
Kenji Okajima ◽  
Mitsuhiro Uchiba ◽  
Kazunori Murakami ◽  
Hiroaki Okabe ◽  
Kiyoshi Takatsuki

2001 ◽  
Vol 7 (3) ◽  
pp. 229-233 ◽  
Author(s):  
Rika Watanabe ◽  
Hideo Wada ◽  
Youichi Miura ◽  
Youichi Murata ◽  
Yasuyuki Watanabe ◽  
...  

In this study, we examined changes in the plasma levels of total plasminogen activator inhibitor-I (PAI-I) and tissue-type plasminogen activator (tPA)/PAI-I complex in patients with disseminated intravascular coagulation (DIC) and in those with thrombotic thrombocytopenic purpura (TTP) to investigate the fibrinolytic function and its relation to organ failure, The plasma levels of total PAI-I and tPA/PAI-I complex were significantly higher in patients with DIC, pre-DIC, and TTP than in those with non-DIC. The plasma levels of thrombin-antithrombin complex (TAT), plasmin-plasmin inhibitor complex (PPIC), D-dimer, thrombomodulin (TM), total PAI-I, and tPA/PAI-I complex were significantly higher in patients with organ failure than in those without organ failure. The plasma levels of total PAI-I and tPA/PAI-I complex were markedly increased in patients with acute leukemia. The plasma levels of total PAI-1, but not those of tPA/PAI-I complex, were significantly increased in patients with sepsis or with solid cancer. In all cases, total PAI-I or tPA/PAI-I complex was not significantly correlated with any hemostatic marker. Measurement of total PAI-I and tPA/PAI-I complex may be useful in the diagnosis of DIC.


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