Thromb Haemost 1971; 25(03): 447-459
DOI: 10.1055/s-0038-1654319
Originalarbeiten – Original Articles – Travaux Originaux
Schattauer GmbH

Factor IX-Inhibitors

Report of Two Cases and a Study of the Biological, Chemical and Immunological Properties of the Inhibitors
K Lechner
1   First Department of Medicine, University of Vienna (Head: Prof. Dr. E. Deutsch)
› Author Affiliations
This work has been supported by a grant from the “Österreichische Fonds zur Förderung der wissenschaftlichen Forschung” Nr. 703 and 900.
Further Information

Publication History

Publication Date:
28 June 2018 (online)

Summary

1. Two patients with severe hemophilia B and an acquired inhibitor against factor IX are described.

2. The inhibitors inactivate factor IX irreversibly. The speed of inactivation is very fast and cannot slowed down by dilution of the inhibitor or by lowering of the incubation temperature. Factor IX of serum is inactivated to a higher degree than factor IX of plasma. Factor IX inhibitors are more sensitive to dilution than factor VIII inhibitors.

3. The inhibitor protein is eluted from the Sephadex G-200 column with the G-peak. On Chromatography on DEAE-cellulose two activity peaks are obtained.

4. Immunologically the inhibitors belong predominantly to the immune globulins of the G-class, but it cannot be excluded that the activity is also associated with IgA. As light chains kappa chains were found in one case.

 
  • References

  • 1 Andersen B. R, Trowp S. B. Gamma G-antibody to human antihemophilic globulin (factor VIII). J. Immunol 100: 175 1968;
  • 2 Bergna L. J, Pavlowsky A. Classification of hemophiliacs with development of an anticoagulant. Actahemat. (Basel.) 16: 247 1956;
  • 3 Breckenridge R. T. VIIth congress of the world federation of hemophilia Baden. 1970 (discussion).
  • 4 Fanti P, Sawers R. J. Anticoagulant specificity and physiologically inactive beta-prothromboplastin. Nature (Lond.) 177: 1233 1956;
  • 5 Fantl P, Sawers R. J, Marr A. G. Investigation of a hemorrhagic disease due to beta-prothromboplastin deficiency complicated by a specific inhibitor of thromboplastin formation. Aust. Ann. Med 05: 163 1956;
  • 6 Goldstein R, Gelfand M, Sanders M, Rosen R. Anticoagulant appearing in plasma thromboplastin component (PTC) deficiency (Abstr.). J. clin. Invest 35: 707 1956;
  • 7 Hardisty R. M. A naturally occuring inhibitor of Christmas factor (factor IX). Thrombos. Diathes. haemorrh. (Stuttg.) 08: 67 1962;
  • 8 Lechner K. A new type of coagulation inhibitor. Thrombos. Diathes. haemorrh. (Stuttg.) 21: 482 1969;
  • 9 Lechner K. Inhibitors in iso- and autoimmune disease. I. Conf. Thrombosis and Hemostasis (Montreux) 1970. Thrombos. Diathes. haemorrh. (Stuttg). 1971 (In press.)
  • 10 Lechner K. Immunologisch bedingte Koagulopatien. Thrombos. Diathes. haemorrh. (Stuttg.) 34: 33 1969;
  • 11 Lewis J. H, Ferguson J. H, Arends T. Hemorrhagic disease with circulating inhibitors of blood clotting: anti-AHF and anti-PTC in eight cases. Blood 11: 846 1956;
  • 12 Margolius A, Jackson D. P, Ratnoff O. D. Circulating anticoagulants: a study of 40 cases and a review of the literature. Medicine (Baltimore.) 40: 145 1961;
  • 13 O’Brien J. R. Un inhibiteur de la maladie de Christmas. Rév. hémat 12: 294 1957;
  • 14 Roberts H. R, Gross G. P, Webster W. P, Dejanow I. I, Penick G. D. Acquired inhibitors to plasma factor IX: A study of their induction, properties and neutralisation. Amer. J. med. Sci 251: 43 1960;
  • 15 Shajpiro S. S. The immunological character of acquired inhibitors of antihemophilic globulin (F VIII) and the kinetics of their interaction with factor VIII. J. clin. Invest 46: 147 1967;
  • 16 Soulier J. P, Larrieu M. J. Differentiation of hemophilia into two groups. A study of thirty-three cases. New Engl. J. Med 249: 547 1953;
  • 17 Spaet T. H, Garner E. S. Resistance to transfusion in hemophilia and deuterohemophilia. Stanf. med. Bull 13: 188 1955;