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March 1984, Vol 138, No. 3 >
Article | March 1984

Vitamin K—Dependent Coagulation Factors in Gram-negative Septicemia FREE

James J. Corrigan, MD
[+] Author Affiliations

Reprint requests to Department of Pediatrics, Arizona Health Sciences Center, 1501 N Campbell Ave, Tucson, AZ 85724 (Dr Corrigan).


Am J Dis Child. 1984;138(3):240-242. doi:10.1001/archpedi.1984.02140410020008.
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• Coagulation studies were performed on 16 children with gram-negative septicemia without the complications of septic shock, liver disease, malnutrition, or laboratory evidence of classic disseminated intravascular coagulation (DIC). Ten (63%) of the 16 cases were found to have abnormal partial thromboplastin and/or prothrombin times. The coagulopathy was caused by a reduction in the vitamin K—dependent coagulation factors. The mechanism that produced this coagulopathy was not known, but evidence was found that suggested that endotoxin may interfere with the vitamin K—carboxylation reaction. The data indicated that abnormal coagulation screening test results in children with gram-negative septicemia were not specific for DIC and that a significant number of patients had a coagulopathy not related to DIC.

(AJDC 1984;138:240-242)

REFERENCES

1 +
Morrison DC, Ulevitch RJ:  The effects of bacterial endotoxins on host mediation systems . Am J Pathol 1978;;93:527-618.
2 +
Yoshikawa T, Tanaka KR, Guze LB:  Infection and disseminated intravascular coagulation . Medicine 1971;;50:237-258.
3 +
Corrigan JJ Jr:  Bacterial infection and disseminated intravascular coagulation , in Eaker D, Wadstrom T (eds): Natural Toxins . New York, Pergamon Press, 1980;, pp 147-154.
4 +
Corrigan JJ Jr, Ray WL, May N:  Changes in the blood coagulation system associated with septicemia . N Engl J Med 1968;;279:851-856.
5 +
Corrigan JJ Jr:  Thrombocytopenia: A laboratory sign of septicemia in infants and children . J Pediatr 1974;;85:219-221.
6 +
McGehee WG, Rapaport SI, Hjort PF:  Intravascular coagulation in fulminant meningococcemia . Ann Intern Med 1967;;67:250-260.
7 +
Goldenfarb PB, Zucker S, Corrigan JJ Jr, et al:  The coagulation mechanism in acute bacterial infection . Br J Haematol 1970;;18:643-652.
8 +
Corrigan JJ Jr:  The vitamin K—dependent proteins . Adv Pediatr 1981;;28:57-74.
9 +
Simone JV, Vanderheiden J, Abildgaard CF:  Semiautomatic one-stage factor VIII assay with commercially prepared standard . J Lab Clin Med 1967;;69:706-712.
10 +
Quick AJ: Hemorrhagic Disease . Philadelphia, Lea & Febiger, 1957;, pp 379-387.
11 +
Owren PA, Aas K:  Control of dicumarol therapy and quantitative determination of prothrombin and proconvertin . Scand J Clin Lab Invest 1951;;3:201-208.
12 +
Hardisty RM, Ingram GIC: Bleeding Disorders: Investigation and Management . Oxford, England, Blackwell Scientific Publications, 1965;, pp 169-172.
13 +
Shanberge JM, Matsuoka T, Fukui H:  Simple method for preparation of substrates for one-stage factor V assay . Am J Pathol 1967;;47: 533-537.
14 +
Ratnoff OD, Menzie C:  New method for determination of fibrinogen in small samples of plasma . J Lab Clin Med 1951;;37:316-320.
15 +
Aballi AJ, Karayalcin G, Costales F, et al:  Liver damage in rabbits from administration of a single dose of gram-negative endotoxin . Pediatr Res 1978;;12:646-651.
16 +
Ramachandran S, Godfrey JJ, Perera MVF:  Typhoid hepatitis . JAMA 1974;;230:236-240.
17 +
Kleinmaier H, Goergen K, Lasch HG, et al:  Untersuchunger dur Frage der Gerinnungsstorung beim Sanarelli-Shwartzman-Phanomen (sog, generalisierten Shwartzman Phanomen) des Kaninches . Z Gesamte Inn Med 1959;;132:275-294.
18 +
Rapaport SI, Hjort PF, Patch MJ, et al:  Consumption of serum factors and prothrombin during intravascular clotting in rabbits . Scand J Haematol 1966;;3:59-75.
19 +
West R, Elovitz MJ, Hardaway RM:  Blood coagulation factor activity in experimental endotoxemia . Ann Surg 1966;;163:567-572.
20 +
Lerner RG, Rapaport SI, Spitzer JM:  Endotoxin-induced intravascular clotting: The need for granulocytes . Thromb Haemost 1968;;20:430-443.
21 +
Izak G, Galewsky K:  Studies on experimentally induced hypercoagulable state in rabbits . Thromb Haemost 1966;;16:228-242.
22 +
Shen SM-C, Rapaport SI, Feinstein DI:  Intravascular clotting after endotoxin in rabbits with impaired intrinsic clotting produced by a factor VIII antibody . Blood 1973;;42:523-534.
23 +
Corrigan JJ Jr, Sell EJ, Pagel C:  Hageman factor and disseminated intravascular coagulation (DIC) in newborns and rabbits . Pediatr Res 1977;;11:916-920.
24 +
Shapiro SS, McKay DG:  The prevention of the generalized Shwartzman reaction with sodium warfarin . J Exp Med 1958;;107:377-381.
25 +
Garner R, Evensen SA:  Endotoxin-induced intravascular coagulation and shock in dogs: The role of factor VII . Br J Haematol 1974;;27:655-668.
26 +
Hangen J:  Intravascular clearance of endotoxin in warfarin-treated rabbits . Ada Pathol Microbiol Immunol Scand B 1972;;80:305-313.

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References

1 +
Morrison DC, Ulevitch RJ:  The effects of bacterial endotoxins on host mediation systems . Am J Pathol 1978;;93:527-618.
2 +
Yoshikawa T, Tanaka KR, Guze LB:  Infection and disseminated intravascular coagulation . Medicine 1971;;50:237-258.
3 +
Corrigan JJ Jr:  Bacterial infection and disseminated intravascular coagulation , in Eaker D, Wadstrom T (eds): Natural Toxins . New York, Pergamon Press, 1980;, pp 147-154.
4 +
Corrigan JJ Jr, Ray WL, May N:  Changes in the blood coagulation system associated with septicemia . N Engl J Med 1968;;279:851-856.
5 +
Corrigan JJ Jr:  Thrombocytopenia: A laboratory sign of septicemia in infants and children . J Pediatr 1974;;85:219-221.
6 +
McGehee WG, Rapaport SI, Hjort PF:  Intravascular coagulation in fulminant meningococcemia . Ann Intern Med 1967;;67:250-260.
7 +
Goldenfarb PB, Zucker S, Corrigan JJ Jr, et al:  The coagulation mechanism in acute bacterial infection . Br J Haematol 1970;;18:643-652.
8 +
Corrigan JJ Jr:  The vitamin K—dependent proteins . Adv Pediatr 1981;;28:57-74.
9 +
Simone JV, Vanderheiden J, Abildgaard CF:  Semiautomatic one-stage factor VIII assay with commercially prepared standard . J Lab Clin Med 1967;;69:706-712.
10 +
Quick AJ: Hemorrhagic Disease . Philadelphia, Lea & Febiger, 1957;, pp 379-387.
11 +
Owren PA, Aas K:  Control of dicumarol therapy and quantitative determination of prothrombin and proconvertin . Scand J Clin Lab Invest 1951;;3:201-208.
12 +
Hardisty RM, Ingram GIC: Bleeding Disorders: Investigation and Management . Oxford, England, Blackwell Scientific Publications, 1965;, pp 169-172.
13 +
Shanberge JM, Matsuoka T, Fukui H:  Simple method for preparation of substrates for one-stage factor V assay . Am J Pathol 1967;;47: 533-537.
14 +
Ratnoff OD, Menzie C:  New method for determination of fibrinogen in small samples of plasma . J Lab Clin Med 1951;;37:316-320.
15 +
Aballi AJ, Karayalcin G, Costales F, et al:  Liver damage in rabbits from administration of a single dose of gram-negative endotoxin . Pediatr Res 1978;;12:646-651.
16 +
Ramachandran S, Godfrey JJ, Perera MVF:  Typhoid hepatitis . JAMA 1974;;230:236-240.
17 +
Kleinmaier H, Goergen K, Lasch HG, et al:  Untersuchunger dur Frage der Gerinnungsstorung beim Sanarelli-Shwartzman-Phanomen (sog, generalisierten Shwartzman Phanomen) des Kaninches . Z Gesamte Inn Med 1959;;132:275-294.
18 +
Rapaport SI, Hjort PF, Patch MJ, et al:  Consumption of serum factors and prothrombin during intravascular clotting in rabbits . Scand J Haematol 1966;;3:59-75.
19 +
West R, Elovitz MJ, Hardaway RM:  Blood coagulation factor activity in experimental endotoxemia . Ann Surg 1966;;163:567-572.
20 +
Lerner RG, Rapaport SI, Spitzer JM:  Endotoxin-induced intravascular clotting: The need for granulocytes . Thromb Haemost 1968;;20:430-443.
21 +
Izak G, Galewsky K:  Studies on experimentally induced hypercoagulable state in rabbits . Thromb Haemost 1966;;16:228-242.
22 +
Shen SM-C, Rapaport SI, Feinstein DI:  Intravascular clotting after endotoxin in rabbits with impaired intrinsic clotting produced by a factor VIII antibody . Blood 1973;;42:523-534.
23 +
Corrigan JJ Jr, Sell EJ, Pagel C:  Hageman factor and disseminated intravascular coagulation (DIC) in newborns and rabbits . Pediatr Res 1977;;11:916-920.
24 +
Shapiro SS, McKay DG:  The prevention of the generalized Shwartzman reaction with sodium warfarin . J Exp Med 1958;;107:377-381.
25 +
Garner R, Evensen SA:  Endotoxin-induced intravascular coagulation and shock in dogs: The role of factor VII . Br J Haematol 1974;;27:655-668.
26 +
Hangen J:  Intravascular clearance of endotoxin in warfarin-treated rabbits . Ada Pathol Microbiol Immunol Scand B 1972;;80:305-313.

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