We measured levels of protein C inhibitor in patients with disseminated intravascular
coagulation (DIC) and liver disease using a functional assay. Levels in 24 normal
subjects averaged 93% of the amount in normal pooled plasma, giving a normal range
of 65 to 121%. Levels were below normal in 8 of 17 patients with DIC, in 4 of 19 patients
with liver cirrhosis, and in 3 patients with acute hepatic necrosis. Levels were normal
or elevated in 9 of 10 patients with cirrhosis and accelerated fibrinolysis, and in
6 patients receiving warfarin. We conclude that protein C inhibitor may be involved
in regulation of protein C activity during pathologic activation of the hemostatic
system (DIC). Decreased protein C inhibitor does not appear to contribute to the pathogenesis
of accelerated fibrinolysis in liver disease. The liver may be the site of synthesis
of protein C inhibitor.
Keywords
Protein C - Protein C inhibitor - Disseminated intravascular coagulation - Liver disease
