Studies on pathological plasma proteolysis in patients with acute pancreatitis. A preliminary report

Changes in the plasma proteolytic enzyme systems were studied in 14 patients with acute pancreatitis. Ten patients survived whereas four died. In both survivors and fatal cases a high frequency of reduced values of plasma prekallikrein (PKK) functional antithrombin III (AT III) and platelets were found during the first week after admission. These changes were seen together with increased serum FDP values and the presence of soluble fibrin. In the fatal cases PKK, AT III, platelets and functional kallikrein inhibition values observed during the first week after admission, were found significantly more reduced than in the survivors. These observations underline that activation of proteases in plasma is an important pathophysiological mechanism in this state, and that evaluation of this process in patients with acute pancreatitis might give information of prognostic value.