Abstract
Antithrombin (AT) is the most important inhibitor of activated coagulation enzymes.
Deficiency of this protein can be a congenital defect. Different types have been described
with a diminution of the entire molecule as well as diminution of activity only with
normal concentration and normal activity and concentration but with a decreased sensitivity
to heparin. There exist also different types of acquired deficiency due to a diminished
production, an increased loss or an increased consumption of the inhibitor. Because
AT deficiency is the cause of an increased thrombotic tendency in many cases the therapeutic
and prophylactic possibilities are described. Since highly purified concentrates became
available, substitution was attempted in cases of AT deficiency. It was found to be
of greatest importance in cases of disseminated intravascular coagulation (DIC) which
is a frequent consequence of septic or traumatic shock. In such cases an adequate
AT-substitution can even be lifesaving as could be shown in different trials
Keywords:
Antithrombin (AT) - AT deficiency - AT concentrates - heparin - DIC - sepsis
