[Pi phenotypes of alpha-1-antitrypsin and antiproteases in meningococcal sepsis]

Values of mean antiproteases were studied in 60 children with meningococcal sepsis. At illness onset, increased levels of alpha-1 antiquimotrypsin (p less than 0.001) and decreased of alpha-2 macroglobulin (p less than 0.001) were found. Moreover, patients who were complicated with a disseminated intravascular coagulation (DIC) also showed a decrease of antithrombin III (p less than 0.001) and inter alpha-1 trypsin inhibitor (p less than 0.001). There was not relationship between antiproteases levels and mortality. In 33 cases the measures were repeated 24 hours later, but no homogeneous results were found, in spite of alpha-2 macroglobulin fall in patients complicated with DIC (p less than 0.05). Phenotypic variants of alpha-1 antitrypsin were studied in 47 cases by isoelectric focusing. Results did not provide evidence that "abnormal phenotypes" (no-Pi MM) could facilitate meningococcal sepsis or DIC, but an increased number of "abnormal phenotypes" (5/9) were found in dead patients (p less than 0.025).