Abstract
Functional protein C (PC) activity (both anticoagulant and amidolytic) was measured using a specific PC activator extracted from the venom of Agkistrodon contortrix in 4 patients with hereditary PC deficiency, 37 with disseminated intravascular coagulation (DIC), 9 with thrombotic thrombocytopenic purpura (TTP), 8 with diabetes mellitus (DM), 8 with liver injury and 30 under long-term warfarin therapy. The results were compared with those obtained by an immunological assay (ELISA). In patients with hereditary PC deficiency, DIC and TTP, PC activity was closely related with PC antigen levels. Both functional and immunological PC were decreased in many patients with DIC, while most TTP patients had normal PC levels. Some DM patients had high PC antigen levels, and their PC activity was somewhat lower than the antigen levels. PC activity and antigen were decreased in patients with hepatic injury, but in some of them functional assays (especially anticoagulant assay) gave lower PC values than the immunoassay. During stabilized warfarin treatment, PC antigen and amidolytic activity were decreased in parallel, but a decrease in anticoagulant activity was more pronounced. In addition, only anticoagulant activity correlated significantly with thrombotest values.These results indicate that the measurement of PC activity is valuable for the assessment of the behavior of PC in various disease states. Only anticoagulat PC assay can evaluate the PC function in patients under oral anticoagulant therapy and in some patients with hepatic injury.
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