Changes in plasma complement system in relation to the coagulation and fibrinolysis systems in obstructive jaundice

Abstract

In addition to the coagulation and fibrinolytic activities, changes in plasma C3, C4 and C1INH levels were investigated in 52 patients with obstructive jaundice. Increase of fibrinogen levels and prolongation of euglobulin lysis time (ELT) were the common features in patients without cholangitis. Whereas, patients with cholangitis showed more prominent prolongation of activated partial thromboplastin time and ELT, and reduction of thrombotest values, hepaplastintest (HPT) values, antithrombin III levels and plasminogen levels than those without cholangitis. These abormalities improved favorably after the appropriate biliary drainage. A marked reduction of plasminogen levels associated with prolonged ELT was considered to be an unfavorable sign suggesting a significant risk of major complications especially acute gastrointestinal hemorrhage and shock after the biliary drainage. The postoperative rise of HPT values and plasminogen levels, which occurred generally in the control group, was not proved in the patients who had the postoperative complications especially gastrointestinal hemorrhage and liver failure.Among the complement system, levels of C3, C4 and C1INH showed a significant increase in obstructive jaundice. Increased levels of C3 and C1INH improvedd significantly after the biliary drainage. There was a significant correlation between the levels of C1INH and ELT. This result suggested that the increase of plasma C1INH levels should play a certain role in decrease of fibrinolytic activity in obstructive jaundice.