Download PDF
Thromb Haemost 1962; 08(02): 221-234
DOI: 10.1055/s-0038-1655422
Originalarbeiten — Original Articles — Travaux Originaux
Schattauer GmbH

Severe Isolated Prothrombin Deficiency : an Acquired State with Complete Recovery[*]

Simon Karpatkin   **
1   Department of Pathology The University of North Carolina School of Medicine, Chapel Hill
,
G.I.C Ingram   *
1   Department of Pathology The University of North Carolina School of Medicine, Chapel Hill
,
John B. Graham   *
1   Department of Pathology The University of North Carolina School of Medicine, Chapel Hill
› Author Affiliations
Further Information

Publication History

Publication Date:
14 May 2019 (online)

Also available at
  PDF Download  Permissions and Reprints

Summary

A 62 year old man acquired a temporary, virtually complete, deficiency of prothrombin as measured by both the Iowa and Oxford 2-stage methods. The etiology agent (or agents) is not known, but one of the drugs listed in Table 1 or an interaction between several was probably responsible. There was no evidence of an inhibitor, and factors I (fibrinogen), V (AcG), VII (SPCA), VIII (AHF), IX (PTC), X (Stuart), and XII (Hageman) were demonstrated to be normal. There were other evidences of mild liver damage and the prothrombin deficiency did not respond immediately to injections of natural vitamin K. Greatly prolonged clotting times but only moderately prolonged prothrombin times and partial thromboplastin times were observed. Bleeding was very severe into many tissues. Thromboplastin generation proceeded normally in the patient’s pro-thrombin-deficient plasma, despite the appearance of only a trace of thrombin. This patient’s history and clotting profile argue against the concept that factor VII (SPCA) and IX (PTC) are derivatives of prothrombin.

* Supported (in part) by Research Grants H-1333 and H-3140 from the National Institutes of Health, Public Health Sendce.


** Formerly Fellow in Pathology, University of North Carolina; presently Research Fellow in Medicine, Washington University, St. Louis, Missouri.


*** Visiting Associate Professor in Pathology, University of North Carolina (Wellcome Trust Travelling Fellow); Senior Lecturer, The Louis Jenner Laboratory, St. Thomas’s Hospital and Medical School, London.


**** Professor of Pathology.