ISSN 2997-1036
International Journal of Hematology | Vol. 4, No. 9, September 2013 | pp. 65–72
DOI: 10.46882/2013/IJH/000045
Original Article
Title: Coagulation profile and protein C activity variations in adult patients with acute deep vein thrombosis
Names of Authors: Y. Z. Ibrahim¹, A. B. Okafor², C. D. Danjuma³
Authors’ Affiliations: ¹Department of Haematology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria; ²Department of Pathology, University of Ibadan, Ibadan, Nigeria; ³Department of Haematology, University of Maiduguri, Maiduguri, Nigeria
Abstract: Determining baseline functional anticoagulant levels during an acute thrombotic episode helps optimize long-term thrombophilia risk evaluations. This study quantified plasma protein C activity, activated protein C resistance, and prothrombin time in 70 adult patients presenting with acute, Doppler-confirmed lower limb deep vein thrombosis prior to initiating anticoagulation. Plasma functional protein C activity was measured using a chromogenic substrate assay. A transient reduction in protein C activity (< 70%) was identified in 25.7% (18 of 70) of the acute patient cohort. Mean protein C activity during the acute phase was significantly lower (74.2 ± 12.4%) compared to measurements repeated 3 months post-thrombosis after completing warfarization (96.5 ± 11.2%, P < 0.01). True congenital protein C deficiency was confirmed in only 3 patients following familial evaluations and steady-state re-testing. Elevated D-dimer and consumption of natural anticoagulants during active clot propagation can lead to false-positive thrombophilia screens. These findings demonstrate that functional anticoagulant assays should be interpreted cautiously during an acute thrombotic event, and abnormalities should be confirmed after completing initial anticoagulant therapy.
Keywords: Deep vein thrombosis, protein C, thrombophilia, chromogenic assay, coagulation factors
Manuscript Timeline: Received: June 15, 2013; Revised: July 24, 2013; Accepted: August 11, 2013; Published: September 17, 2013