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Heparin cofactor II activity in patients with disseminated intravascular
coagulation and hepatic failure
DM Tollefsen and CA Pestka
Heparin cofactor II (HCII) is a glycoprotein in human plasma which
inactivates thrombin rapidly in the presence of heparin or dermatan
sulfate. We have developed a functional assay for HCII in which inhibition
of thrombin by plasma is determined in the presence of dermatan sulfate.
The assay is specific for HCII by the following criteria: (a) under the
conditions of the assay, 125I-thrombin forms complexes in plasma which
comigrate with the thrombin-HCII complex during sodium dodecyl sulfate
polyacrylamide gel electrophoresis (SDS- PAGE); (b) activity detected by
the assay is decreased in plasma absorbed with monospecific antibodies
against HCII; and (c) purified antithrombin III (ATIII) is unreactive in
the assay system. Addition of Polybrene to the assay permits determination
of HCII activity in samples containing less than or equal to 12 U/mL of
heparin. The range of HCII concentrations in normal individuals is 1.2 +/-
0.4 mumol/L (mean +/- 2 SD, n = 34). HCII activity was determined in 54
consecutive patients undergoing evaluation for the possibility of
disseminated intravascular coagulation (DIC). Ten of the 11 patients with
documented DIC had decreased HCII activity as compared with only 7 of the
43 patients without DIC (chi 2 = 19.3, P less than .0001). The
concentrations of HCII and ATIII varied in parallel in most of the patients
tested. A significant correlation between decreased HCII activity and
decreased serum albumin concentration was also observed in these patients
and in eight additional patients with hepatic failure in the absence of
DIC. We conclude that HCII activity is decreased in many patients with DIC
and hepatic failure.
Volume 66,
Issue 4,
pp. 769-774,
10/01/1985
Copyright © 1985 by The American Society of Hematology
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