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Thromb Haemost 1995; 73(03): 368-373
DOI: 10.1055/s-0038-1653782
Original Articles
Clinical Studies
Schattauer GmbH Stuttgart

Early Markers of Blood Coagulation and Fibrinolysis Activation in Argentine Hemorrhagic Fever

M V Heller
1   Instituto de Investigaciones Médicas Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires, Argentina, The Netherlands
,
R F Marta
2   The Academic Hospital, Leiden, The Netherlands
,
A Sturk
2   The Academic Hospital, Leiden, The Netherlands
,
J I Maiztegui
3   Institute Nacional de Estudios de Virosis Hemorragicas (INEVH), Pergamino, The Netherlands
,
C E Hack
4   Central Laboratory of the Blood Transfusion Service, Amsterdam, The Netherlands
,
J W ten Cate
5   Academic Medical Center, Amsterdam, The Netherlands
,
F C Molinas
1   Instituto de Investigaciones Médicas Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires, Argentina, The Netherlands
› Author Affiliations
Further Information

Publication History

Received22 August 1994

Accepted after resubmission 01 December 1994

Publication Date:
09 July 2018 (online)

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Summary

Junin virus, an arenaviridae, is the etiological agent of Argentine hemorrhagic fever. In addition to thrombocytopenia, patients present several alterations in both the blood coagulation and the fibrinolytic system, but diffuse intravascular coagulation could not be demonstrated. To investigate further the activation status of the two systems, levels of thrombin-antithrombin complexes (TAT), prothrombin fragment 1+2, protein C, total and free protein S, C4bBP, antithrombin III, t-PA, PAI-1 and D-dimer were measured. Fourteen patients with a confirmed diagnosis of Argentine hemorrhagic fever were included in the study, 2 were severe, 3 moderate and 9 mild clinical cases, but hemorrhages were slight throughout. Blood samples were collected for 6 consecutive days on admission and on remission. At admission TAT and F1+2 levels were increased in 13/14 patients, reaching 0.33 nM (0.06-0.87) and 2.16 nM (0.96-6.5), respectively. PC was low in 4 cases, fPS in 6 and tPS in 2, whereas C4bBP and ATIII values were within normal range. t-PA and D-dimer levels were high in 11/14 patients, reaching 20 ng/ml (2.7-106) and 1660 ng/ml (877-3780) respectively, while PAI-1 was considerably increased in the 2 severe cases and normal in the remainder. These results suggest low level though persistent process of blood coagulation and fibrinolysis activation in this viral hemorrhagic disease. We believe these abnormalities may lead to the well described bleeding manifestations in these patients.

 

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