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Thromb Haemost 1959; 03(02): 237-256
DOI: 10.1055/s-0038-1654385
Originalarbeiten — Original Articles — Travaux Originaux
Schattauer GmbH

Prothrombin as Co-Factor of the Circulating Anticoagulant in Systemic Lupus Erythematosus?

A Loeliger
1   Clinic for Internal Medicine (Director: Prof. J. Mulder), University Hospital, Leyden, Holland
,
with the technical assistance of Miss,
E. J. J Alsbach
1   Clinic for Internal Medicine (Director: Prof. J. Mulder), University Hospital, Leyden, Holland
› Author Affiliations
We wish to thank colleague G. J. Sas, specialist in internal medicine in Dordrecht, for kindly putting his data at our disposal.
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Publication History

Publication Date:
08 June 2018 (online)

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Summary

A 35-year old man with lupus erythematosus of the skin is demonstrated, who also shows signs of systemic L. E.: sometimes slightly increased ESR, varying thrombocytopenia, slightly prolonged coagulation and prothrombin time, positive cepnalin-cholesterol flocculation test, biologically false positive syphilis reactions and signs of a slightly increased haemolysis. Electrophoretic examination of the serum proteins presents practically normal values, certainly no hypergammaglobulinaemia. Analytical examination of coagulation reveals hypoprothrombinaemia and an anticoagulant most probably directed against thrombocyte factor 3, intrinsic thromboplastin and tissue thromboplastin. The anticoagulant seems to be only active in the presence of prothrombin. Prothrombin therefore, is considered a co-factor of the anticoagulant. The inactive anticoagulant is localized in the gamma globulins. The possible cause of the hypoprothrombinaemia (immune reaction?) and the data in the literature are discussed.


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  • References

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  • References

  • 1 Barkhan P. Observations on a coagulation defect characterised by thrombocytopenia with a circulating anticoagulant. S. Afr. J. med. Sci 1952; 17: 87
    PubMedSearch in Google Scholar
  • 2 Biggs R, Macfarlane R. G. Human blood coagulation and its disorders. Black-well Scientific Publ; Oxford: 1957
    Search in Google Scholar
  • 3 Bonnin J. A, Cohen A. K, Hicks N. D. Coagulation defects in a case of systemic lupus erythematosus with thrombocytopenia. Brit. J. Haematol 1956; 2: 168
    CrossrefPubMedSearch in Google Scholar
  • 4 Conley C. L, Hartmann R. C. A hemorrhagic disorder caused by circulating anticoagulant in patients with disseminated lupus erytematosus. J. clin. Invest 1952; 31: 621
    PubMedSearch in Google Scholar
  • 5 Dameshek W. Systemic lupus erythematosus: A complex auto-immune disorder? Ann. internat. Med 1958; 48: 707
    PubMedSearch in Google Scholar
  • 6 AAAAAFrick P. G. Acquired circulating anticoagulants in systematic “collagen disease”. Blood 1955; 10: 691
    PubMedSearch in Google Scholar
  • 7 Hartert H. Klinische Blutgerinnungsstudien mit der Thrombelastographie. Dtsch. Arch. klin. Med 1952; 199: 284 (293, 402, 414)
    PubMedSearch in Google Scholar
  • 8 van Herwerden M. A. Een eenvoudige telmethode voor bloedplaatjes. Ned. T. Geneesk 1915; 11: 1866
    PubMedSearch in Google Scholar
  • 9 Hicks N. D, Pitney W. R. A rapid screening test for disorders of thromboplastin generation. Brit. J. Haematol 1957; 3: 227
    CrossrefPubMedSearch in Google Scholar
  • 10 Hitzig W. H, Labhart A, Uehlinger E. Transitorische Hemmkörperhämo-philie bei Rheumatismus. Helv. med. Acta 1951; 18: 410
    PubMedSearch in Google Scholar
  • 11 Kovács E. Steigerung der endogenen Antithrombokinase-Produktion bei Lungenembolie und Myokardinfarkt. Thromb. Diath. haem 1957; 1: 541
    PubMedSearch in Google Scholar
  • 12 Laurell A. B, Nilsson I. M. Hypergammaglobulinemia, circulating anticoagulant, and biologic false positive Wassermann reaction. J. Lab. clin. Med 1957; 49: 694
    PubMedSearch in Google Scholar
  • 13 Lee S. L. Laboratory studies in systemic lupus erythematosus. AMA Arch. Dermat 1956; 73: 313
    PubMedSearch in Google Scholar
  • 14 Lee S. L, Sanders M. A disorder of blood coagulation in systemic lupus erythematosus. J. clin. Invest 1955; 34: 1814
    CrossrefPubMedSearch in Google Scholar
  • 15 Ley A. B, Reader G. G, Sorenson C. W, Overman R. S. Idiopathic hypoprothrombinemia associated with hemorrhagic diathesis and the effect of vitamin K. Blood 1951; 6: 740
    CrossrefPubMedSearch in Google Scholar
  • 16 Loeliger A. Über den Nachweis eines neuen Blutgerinnungsfaktors: Faktor VIL Wien. Z. inn. Med 1952; 33: 169
    PubMedSearch in Google Scholar
  • 17 Loe liger A, Hers J. F. Ph. Chronic Antithrombinaemia (Antithrombin V) with haemorrhagic diathesis in a case of rheumatoid arthritis with hypergammaglobulinaemia. Thromb. Diath. haem 1957; 1: 499
    PubMedSearch in Google Scholar
  • 18 Mueller J. F, Ratnoff O, Heinle R. W. Observations on the characteristics on an unusual circulating anticoagulant. J. Lab. clin. Med 1951; 38: 254
    PubMedSearch in Google Scholar
  • 19 Owren P. A, Aas K. The control of dicumarol therapy and the quantitative determination of prothrombin and proconvertin. Scand. J. clin. Lab. Invest 1951; 3: 201
    CrossrefPubMedSearch in Google Scholar
  • 20 vanderPol E. T, Kettenborg H. K, de Vries S. L. Een modificatie van de “thrombin generation test”. Ned. T. Geneesk 1956; 100: 1900
    PubMedSearch in Google Scholar
  • 21 Post C. R, den Ottolander G. J. H, Hoorweg P. G. Een familiale vorm van idiopathische hypoprothrombinaemie. Ned. T. Geneesk 1956; 100: 1981
    PubMedSearch in Google Scholar
  • 22 Quick A. J. Hemorrhagic diseases. Lea & Febiger; Philadelphia: 1957
    Search in Google Scholar
  • 23 Ramot C, Singer K. An unusual circulating anticoagulant in systemic lupus erythematosus. Acta haemat. (Basel) 1956; 16: 158
    CrossrefPubMedSearch in Google Scholar
  • 24 Seligmann M. Etudes immunologiques sur le lupus érythémateux disséminé. Rev. Franç. d’Etud. Clin. et Biol 1958; 3: 558
    PubMedSearch in Google Scholar
  • 25 Seligmann M, Milgrom F, Trefouel J. Mise en évidence par la fixation du complément de la réaction entre acide désoxyribonucléique et sérum de malades atteints de lupus érythémateux disséminé. C. R. Acad. Sci. (Paris) 1958; 245: 1472
    PubMedSearch in Google Scholar
  • 26 Swift S. A serum anticoagulant factor in systemic lupus erythematosus. AMA Arch. Dermat 1956; 74: 296
    PubMedSearch in Google Scholar
  • 27 Verstraete M, Vandenbroucke J. Occurence and mode of action of endogenous circulating anticoagulant. J. Lab, clin. Med 1956; 48: 673
    PubMedSearch in Google Scholar

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