[Plasma factor VII levels in disseminated intravascular coagulation]

Area of Science:

• Hematology
• Coagulation Science
• Pathophysiology

Context:

• Disseminated intravascular coagulation (DIC) is a complex syndrome characterized by widespread activation of coagulation.
• The extrinsic pathway of coagulation plays a role in hemostasis and thrombosis.
• Understanding the activation of coagulation pathways in DIC is crucial for diagnosis and management.

Purpose:

• To evaluate the activation of the extrinsic pathway of coagulation in patients with DIC.
• To measure plasma factor VII coagulant activity (FVIIc) and antigen levels (FVIIag) in DIC patients.
• To correlate factor VII levels with other hemostatic parameters and clinical conditions.

Summary:

• Plasma FVIIc and FVIIag were significantly lower in 56 DIC patients compared to controls, indicating consumption.
• Lower factor VII levels correlated with reduced antithrombin III and plasminogen activities.
• Elevated factor VII levels in some DIC patients suggest compensatory liver synthesis.
• Pathologic endothelial stimulation, indicated by tPA-PAI-I complex, negatively correlated with FVIIag, suggesting extrinsic pathway activation.
• The FVIIc/FVIIag ratio correlated with FDP and fibrin monomer, reflecting factor VII zymogen activation.

Impact:

• This study reveals that factor VII consumption is a key feature of DIC, linked to reduced anticoagulant and profibrinolytic factors.
• Findings highlight the role of endothelial stimulation in activating the extrinsic pathway during DIC.
• The study provides insights into the complex hemostatic alterations in DIC, particularly concerning factor VII dynamics.