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Updated: Oct 1, 2026
Measurement of Factor V Activity in Human Plasma Using a Microplate Coagulation Assay
Published on: September 9, 2012
[Natural coagulation inhibitors; antithrombin III, protein C, protein S in children with hypercoagulation due to
G Wygledowska1, J Grygalewicz, E Matuszewska
1Klinika Pediatrii, CMKP, Czerniakowska, 00-416 Warszawa, Poland.
Insights
In children with nephrotic syndrome, antithrombin III (AT III) and protein S levels are low, while protein C is high. Steroid therapy impacts AT III and protein C activity, suggesting a role in managing coagulopathy.
Area of Science:
- Pediatric Nephrology
- Hematology
- Coagulation Science
Context:
- Nephrotic syndrome in children is associated with significant hemostatic alterations.
- Understanding these changes is crucial for managing potential thrombotic complications.
Purpose:
- To evaluate the activity of antithrombin III (AT III), protein C, and protein S in children with nephrotic syndrome.
- To assess the impact of steroid therapy on these coagulation inhibitors.
Summary:
- At disease onset, children with nephrotic syndrome showed decreased AT III and protein S activity, and increased protein C activity compared to controls.
- Steroid therapy led to increased AT III and protein C activity, while protein S remained unchanged.
- Changes in AT III and protein C suggest their involvement in the inflammatory and coagulopathic processes of nephrotic syndrome.
Impact:
- Findings highlight the complex interplay of coagulation factors in pediatric nephrotic syndrome.
- The study questions the efficacy of the protein C-protein S complex in this condition.
- Increased AT III activity during early treatment may mitigate the risk of thromboembolic events.
Unlabelled:
Activity of AT HI, protein C and protein S was evaluated in 58 children with nephrotic syndrome aged between 2-17 years and in 50 healthy children aged between 2-16 years serving as a control group. In children with nephrotic syndrome measurements were conducted at three different stages of disease: onset, improvement and remission. The aim was to assess the effect of steroid therapy on activity of the above inhibitors.
Results:
At the onset of the disease, activity of AT III and protein S were found to be significantly decreased whereas activity of protein C was significantly increased as compared with the control group. Activity of AT III lowered at the onset of the disease, was significantly higher during both the improvement and the remission stage. Activity of protein C, increased at the onset of the nephrotic syndrome, decreased progressively and significantly during the improvement stage and then again increased markedly during the remission. Activity of protein S, lowered at the onset and during the improvement stage of the nephrotic syndrome, significantly rose during the remission, but never reached levels observed in the control group. Activity of AT III and protein C within 72 hours after introduction of steroids increased without any marked alterations in the clinical and biochemical course of the nephrotic syndrome. Activity of protein S was not changed.
Conclusions:
There are marked changes in AT III and protein C activity in children with nephrotic syndrome. It is expected that these proteins are involved in inhibition of the inflammatory process and of the local and systemic coagulopathy. Raised activity of protein C is not accompanied by increased activity of protein. This arouses doubts as to whether protein C-protein S complex is effective in inhibition of inflammation and limitation of coagulopathy. That role may be played AT III, which with its sufficient rise at the early stage of treatment may limit the risk of thromboembolic complications in children with nephrotic syndrome.
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