Increased Factor VIII Complex in Fulminant Hepatic Failure

 

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Summary

In 30 patients with fulminant hepatic failure (FHF) all three components of the factor VIII complex were significantly increased (VIIIC = 6.43 ± 1.12 u/ml; VIIIRAg = 3.91 ± 0.25 u/ ml; VIIIvWF = 3.89 ± 0.29 u/ml). There was good correlation between all three parameters in control subjects, but only between VIIIRAg and VIIIvWF (r= 0.67; p <0.001) in patients with FHF. VIIIC was significantly higher than VIIIRAg and VIIIvWF. These results suggest that VIIIC and VIIIRAg are increased by different mechanisms in FHF. These processes may include endothelial cell damage, reduced reticuloendothelial system function and lack of production of inactivating substances by the damaged liver.

Platelet adhesion to glass beads was increased in FHF (36.4 ± 5.9% compared to 16.6 ± 2.1%, p <0.01). There was no significant correlation between platelet adhesion and any of the parameters of the factor VIII complex. Thus the increase in platelet adhesion cannot be due to the increase in VIIIvWF in FHF.

• References

• 1 Lechner K, Niessner H, Thaler E. Coagulation abnormalities in liver disease. Semin Thromb Haemostas 1977; 4: 40-56
  Article in Thieme ConnectPubMedGoogle Scholar
• 2 Bloom AL. Intravascular coagulation and the liver. Br J Haematol 1975; 30: 1-7
  CrossrefPubMedGoogle Scholar
• 3 Baele G, Matthijs E, Barbier F. Antihaemophilic factor activity, F-VIII related antigen and von Willebrand factor in hepatic cirrhosis. Acta Haematol 1977; 57: 290-297
  CrossrefPubMedGoogle Scholar
• 4 Van Outryve M, Baele G, De Weerdt GA, Barbier F. Antihaemophilic factor A (FVIII) and serum fibrin-fibrinogen degradation products in hepatic cirrhosis. Scand J Haematol 1973; 11: 148-152
  PubMedGoogle Scholar
• 5 Bertaglia E, Pelmonte P, Vertolli U, Azzurro M, Martines D. Bleeding in cirrhotic patients. A precipitating factor due to intravascular coagulation or to hepatic failure. Haemostasis 1983; 13: 328-334
  PubMedGoogle Scholar
• 6 Hoyer LW. The factor VIII complex. Structure and function. Blood 1981; 58: 1-13
  PubMedGoogle Scholar
• 7 Hellem AJ. Platelet adhesiveness in von Willebrand’s disease. A study with a new modification of the glass bead filter method. Scand J Haematol 1970; 7: 374-382
  PubMedGoogle Scholar
• 8 Meili EO, Straub PW. Elevation of factor VIII in acute fatal liver necrosis. Thrombos Diathes Haemorrh 1970; 24: 161-174
  PubMedGoogle Scholar
• 9 Meili EO, Frick PG, Straub PW. Coagulation changes during massive hepatic necrosis due to amanita phalloides poisoning with special reference to antihemophilic globulin. Helv Med Acta 1970; 35: 304-313
  PubMedGoogle Scholar
• 10 Rubin MH, Weston MJ, Bullock G, Roberts J, Langley PG, White YS, Williams R. Abnormal platelet function and ultrastructure in fulminant hepatic failure. Q J Med 1977; 46: 339-352
  PubMedGoogle Scholar
• 11 Langley PG, Hughes RD, Williams R. Platelet adhesiveness to glass beads in liver disease. Acta Haematol 1982; 67: 124-127
  CrossrefPubMedGoogle Scholar
• 12 Cejka J. Enzyme immunoassay for factor VUI-related antigen. Clin Chem 1982; 28: 1356-1358
  CrossrefPubMedGoogle Scholar
• 13 Canalese J, Gove CD, Gimson AES, Wilkinson SP, Wardle EN, Williams R. Reticuloendothelial system and hepatocyte function in fulminant hepatic failure. Gut 1982; 23: 265-269
  CrossrefPubMedGoogle Scholar
• 14 Brunswig D. Factor VIII related protein - an indicator of Kupffer cell function. In: The reticuloendothelial system and pathogenesis of liver disease ed Liehr H, Grun M. Elsevier; 1980: 295-300
• 15 Milani L, Merkel C, Cavel F, Gasparotto ML, Gatta A. Relationship between plasma levels of factor VIII related antigen and reticuloendothelial function in chronic uremia. Clin Nephrol 1983; 20: 235-238
  PubMedGoogle Scholar
• 16 Lombardi R, Mannucci PM, Seghatchian MJ, Vicente Garcia V, Coppola R. Alterations of factor VIII von Willebrand factor in clinical conditions associated with an increase in its plasma concentration. Br J Haematol 1981; 49: 61-68
  CrossrefPubMedGoogle Scholar
• 17 Trovati M, Tamponi G, Marra S, Lorenzati R, Schinco P, Bazzan M, Vitali S, Cavalot F, Pagano G, Lenti G. Exercise-induced changes of factor VIII complex in healthy subjects and type-1 diabetics: relation between growth hormone and von Willebrand factor increments. Horm Metabol Res 1983; 15: 316-320
  Article in Thieme ConnectPubMedGoogle Scholar
• 18 Kopistky RG, Switzer MEP, Williams RS, McKee PA. The basis for the increase in factor VIII procoagulant activity during exercise. Thromb Haemostas 1983; 49:: 53-57
  PubMedGoogle Scholar
• 19 Chavin SI. Factor VIII - Structure and function in blood clotting. Am J Hematol 1984; 16: 297-306
  CrossrefPubMedGoogle Scholar
• 20 Marlar RA, Kleiss AJ, Griffin JH. Mechanism of action of human activated protein C, a thrombin dependent anticoagulant enzyme. Blood 1982; 59: 1067-1072
  PubMedGoogle Scholar
• 21 Epstein DJ, Bergum PW, Bajaj SP, Rapapport SI. Radioimmunoassays for protein C and factor X. Am J Clin Pathol 1984; 82: 573-581
  CrossrefPubMedGoogle Scholar
• 22 Francis RB, Patch MJ. A functional assay for protein C in human plasma. Thromb Res 1983; 32: 605-613
  CrossrefPubMedGoogle Scholar
• 23 Mannucci PM, Vigano S. Deficiencies of protein C, an inhibitor of blood coagulation. Lancet 1982; 2: 463-466
  PubMedGoogle Scholar
• 24 Wegmuller E, Gruninger U, Furlan M, Beck EA, Hodler J, Reubi FC. Factor VIII activity in chronic renal disease. Nephron 1981; 28: 157-162
  CrossrefPubMedGoogle Scholar