The quantitative association of plasma endotoxin, antithrombin, protein C, extrinsic pathway inhibitor and fibrinopeptide a in systemic meningococcal disease

doi:10.1016/0049-3848(89)90054-6

Thrombosis Research

Volume 55, Issue 4, 15 August 1989, Pages 459-470

https://doi.org/10.1016/0049-3848(89)90054-6 Get rights and content

Abstract

We have evaluated the quantitative relationship between lipopolysaccharide (LPS, endotoxin), fibrinopeptide A (FPA), antithrombin (AT), protein C (PC) and extrinsic pathway inhibitor (EPI) in plasma from 39 consecutively admitted patients with systemic meningococcal disease (SMD). The most severely ill patients with fulminant meningococcal septicemia (n=13, 6 dead) had significantly (p<0.01) higher plasma levels of LPS and FPA and lower levels of PC and AT on admission as compared with the less severe clinical presentations (n=26, 1 dead). The levels of EPI on admission were significantly (p<0.05) higher in nonsurvivors vs survivors with fulminant septicemia. As the disease progressed, the levels of LPS, FPA, AT and PC declined, while the levels of EPI increased. Three of six nonsurviving septicemic patients had levels of EPI >200% within 16 hours of admission vs two of 30 survivors (p=0.02). The results suggest that increasing levels of LPS in SMD elicit increasing consumption coagulopathy, contributing to the organ pathophysiology. The kinetics of EPI, inhibiting the thromboplastin-FVIIa-FXa complex, differs markedly from the kinetics of AT and PC i.e. increases as opposed to decreases.

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PaperThe quantitative association of plasma endotoxin, antithrombin, protein C, extrinsic pathway inhibitor and fibrinopeptide a in systemic meningococcal disease

Abstract

Am. J. Med.

Thromb. Res.

Thromb. Res.

Blood

Thromb. Res.

Blood

J. Biol. Chem.

Tromb. Res.

Blood

Blood

Blood

Thromb. Res.

Intravascular coagulation in fulminant meningococcemia

Annal Int. Med.

Disseminated intravascular coagulation in patients with meningococcal infection: laboratory diagnosis and prognostic factors

Scand J. Infect. Dis.

Increased tissue thromboplastin activity in monocytes of patients with meningococcal infection: related to an unfavourable prognosis

Thromb. Haemostas.

The effects of bacterial endotoxins on host mediation systems

Am. J. Pathol.

Paper
The quantitative association of plasma endotoxin, antithrombin, protein C, extrinsic pathway inhibitor and fibrinopeptide a in systemic meningococcal disease