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An acquired coagulation inhibitor to factor II
British Journal of Haematology
|April 1, 1982
Summary
An elderly woman experienced bleeding due to high antithrombin levels inhibiting clotting factors. Treatment with corticosteroids and immunosuppressants reduced the inhibitor, resolving the bleeding symptoms.
Area of Science:
- Hematology
- Immunology
- Internal Medicine
Background:
- Bleeding disorders can arise from various hemostatic abnormalities.
- Antithrombin is a key regulator of coagulation, primarily inhibiting thrombin.
Observation:
- An elderly woman presented with a bleeding disorder characterized by prolonged activated partial thromboplastin time (PTT), prothrombin time (PT), and thrombin time, but a normal Russell's viper venom time (RVVT).
- Elevated plasma antithrombin levels were detected in the patient.
Findings:
- The patient's plasma contained a high concentration of an IgG antibody that inhibited thrombin and precipitated prothrombin.
- This autoantibody activity was quantified as equivalent to 80 NIH units of thrombin per milliliter.
- The inhibitor was identified as an immunoglobulin G (IgG) autoantibody.
Implications:
- This case highlights a rare cause of acquired coagulation factor deficiency due to autoantibodies against antithrombin.
- The successful management with immunosuppressive therapy suggests an autoimmune etiology.
- Understanding such autoantibodies is crucial for diagnosing and treating complex bleeding disorders.