Increased Factor VIII Complex in Fulminant Hepatic Failure

P G Langley; R D Hughes; Roger Williams

doi:10.1055/s-0038-1660099

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 1985; 54(03): 693-696
DOI: 10.1055/s-0038-1660099

Original Article

Schattauer GmbH Stuttgart

Increased Factor VIII Complex in Fulminant Hepatic Failure

Autoren

P G Langley

The Liver Unit, King’s College Hospital and School of Medicine and Dentistry, London, UK
R D Hughes

The Liver Unit, King’s College Hospital and School of Medicine and Dentistry, London, UK
Roger Williams

The Liver Unit, King’s College Hospital and School of Medicine and Dentistry, London, UK

Abstract

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Summary

In 30 patients with fulminant hepatic failure (FHF) all three components of the factor VIII complex were significantly increased (VIIIC = 6.43 ± 1.12 u/ml; VIIIRAg = 3.91 ± 0.25 u/ ml; VIIIvWF = 3.89 ± 0.29 u/ml). There was good correlation between all three parameters in control subjects, but only between VIIIRAg and VIIIvWF (r= 0.67; p <0.001) in patients with FHF. VIIIC was significantly higher than VIIIRAg and VIIIvWF. These results suggest that VIIIC and VIIIRAg are increased by different mechanisms in FHF. These processes may include endothelial cell damage, reduced reticuloendothelial system function and lack of production of inactivating substances by the damaged liver.

Platelet adhesion to glass beads was increased in FHF (36.4 ± 5.9% compared to 16.6 ± 2.1%, p <0.01). There was no significant correlation between platelet adhesion and any of the parameters of the factor VIII complex. Thus the increase in platelet adhesion cannot be due to the increase in VIIIvWF in FHF.

Keywords

Factor VIII - fulminant hepatic failure

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Referenzen

References
1 Lechner K, Niessner H, Thaler E. Coagulation abnormalities in liver disease. Semin Thromb Haemostas 1977; 4: 40-56
2 Bloom AL. Intravascular coagulation and the liver. Br J Haematol 1975; 30: 1-7
3 Baele G, Matthijs E, Barbier F. Antihaemophilic factor activity, F-VIII related antigen and von Willebrand factor in hepatic cirrhosis. Acta Haematol 1977; 57: 290-297
4 Van Outryve M, Baele G, De Weerdt GA, Barbier F. Antihaemophilic factor A (FVIII) and serum fibrin-fibrinogen degradation products in hepatic cirrhosis. Scand J Haematol 1973; 11: 148-152
5 Bertaglia E, Pelmonte P, Vertolli U, Azzurro M, Martines D. Bleeding in cirrhotic patients. A precipitating factor due to intravascular coagulation or to hepatic failure. Haemostasis 1983; 13: 328-334
6 Hoyer LW. The factor VIII complex. Structure and function. Blood 1981; 58: 1-13
7 Hellem AJ. Platelet adhesiveness in von Willebrand’s disease. A study with a new modification of the glass bead filter method. Scand J Haematol 1970; 7: 374-382
8 Meili EO, Straub PW. Elevation of factor VIII in acute fatal liver necrosis. Thrombos Diathes Haemorrh 1970; 24: 161-174
9 Meili EO, Frick PG, Straub PW. Coagulation changes during massive hepatic necrosis due to amanita phalloides poisoning with special reference to antihemophilic globulin. Helv Med Acta 1970; 35: 304-313
10 Rubin MH, Weston MJ, Bullock G, Roberts J, Langley PG, White YS, Williams R. Abnormal platelet function and ultrastructure in fulminant hepatic failure. Q J Med 1977; 46: 339-352
11 Langley PG, Hughes RD, Williams R. Platelet adhesiveness to glass beads in liver disease. Acta Haematol 1982; 67: 124-127
12 Cejka J. Enzyme immunoassay for factor VUI-related antigen. Clin Chem 1982; 28: 1356-1358
13 Canalese J, Gove CD, Gimson AES, Wilkinson SP, Wardle EN, Williams R. Reticuloendothelial system and hepatocyte function in fulminant hepatic failure. Gut 1982; 23: 265-269
14 Brunswig D. Factor VIII related protein - an indicator of Kupffer cell function. In: The reticuloendothelial system and pathogenesis of liver disease ed Liehr H, Grun M. Elsevier; 1980: 295-300
15 Milani L, Merkel C, Cavel F, Gasparotto ML, Gatta A. Relationship between plasma levels of factor VIII related antigen and reticuloendothelial function in chronic uremia. Clin Nephrol 1983; 20: 235-238
16 Lombardi R, Mannucci PM, Seghatchian MJ, Vicente Garcia V, Coppola R. Alterations of factor VIII von Willebrand factor in clinical conditions associated with an increase in its plasma concentration. Br J Haematol 1981; 49: 61-68
17 Trovati M, Tamponi G, Marra S, Lorenzati R, Schinco P, Bazzan M, Vitali S, Cavalot F, Pagano G, Lenti G. Exercise-induced changes of factor VIII complex in healthy subjects and type-1 diabetics: relation between growth hormone and von Willebrand factor increments. Horm Metabol Res 1983; 15: 316-320
18 Kopistky RG, Switzer MEP, Williams RS, McKee PA. The basis for the increase in factor VIII procoagulant activity during exercise. Thromb Haemostas 1983; 49:: 53-57
19 Chavin SI. Factor VIII - Structure and function in blood clotting. Am J Hematol 1984; 16: 297-306
20 Marlar RA, Kleiss AJ, Griffin JH. Mechanism of action of human activated protein C, a thrombin dependent anticoagulant enzyme. Blood 1982; 59: 1067-1072
21 Epstein DJ, Bergum PW, Bajaj SP, Rapapport SI. Radioimmunoassays for protein C and factor X. Am J Clin Pathol 1984; 82: 573-581
22 Francis RB, Patch MJ. A functional assay for protein C in human plasma. Thromb Res 1983; 32: 605-613
23 Mannucci PM, Vigano S. Deficiencies of protein C, an inhibitor of blood coagulation. Lancet 1982; 2: 463-466
24 Wegmuller E, Gruninger U, Furlan M, Beck EA, Hodler J, Reubi FC. Factor VIII activity in chronic renal disease. Nephron 1981; 28: 157-162