A Prospective Study of Platelets and Plasma Proteolytic Systems during the Early Stages of Rocky Mountain Spotted Fever
| العنوان: | A Prospective Study of Platelets and Plasma Proteolytic Systems during the Early Stages of Rocky Mountain Spotted Fever |
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| المؤلفون: | A. Koneti Rao, Alvin H. Schmaier, William C. Blackwelder, Peter C. Harpel, Jean-Raoul Scherrer, Eugene Sobel, Mary Lou Clements, Stefan Niewiarowski, Robert W. Colman, Andrei Z. Budzynski, Marc Schapira |
| المصدر: | New England Journal of Medicine. 318:1021-1028 |
| بيانات النشر: | Massachusetts Medical Society, 1988. |
| سنة النشر: | 1988 |
| مصطلحات موضوعية: | medicine.medical_specialty, Rocky Mountain spotted fever, Antithrombin III, Platelet Factor 4, Fibrinogen, Fibrin Fibrinogen Degradation Products, Internal medicine, von Willebrand Factor, Blood plasma, medicine, Humans, Platelet, Prospective Studies, Blood Coagulation, Rocky Mountain Spotted Fever, Fibrinopeptide A, Prothrombin time, biology, medicine.diagnostic_test, Platelet Count, business.industry, Fibrinolysis, Vaccination, Prekallikrein, General Medicine, Factor VII, beta-Thromboglobulin, Rickettsia rickettsii, biology.organism_classification, medicine.disease, Endocrinology, Coagulation, Immunology, Prothrombin Time, business, Platelet factor 4, medicine.drug |
| الوصف: | We prospectively examined early changes in platelets and plasma proteolytic systems in 12 vaccinated and 6 unvaccinated volunteers in whom Rocky Mountain spotted fever developed after challenge with Rickettsia rickettsii. The platelet counts declined while the plasma concentration of beta-thromboglobulin and the ratio of beta-thromboglobulin to platelet factor 4 increased, indicating in vivo activation of platelets. Plasma levels of antithrombin III decreased and levels of fibrinopeptide A increased, indicating in vivo activation of the coagulation system. Plasma fibrinogen levels peaked at 24 hours and gradually declined; this is consistent with the behavior of fibrinogen as an acute-phase reactant. Prolongation of the prothrombin time and a decrease in plasma levels of factor VII in the absence of evidence of liver injury suggested possible activation of the extrinsic pathway of coagulation. A decline in plasma prekallikrein levels with an increase in plasma C1-inhibitor-kallikrein complexes suggested activation of kallikrein, probably through the intrinsic coagulation system. Elevations in levels of plasma fibrin-degradation products and alpha 2-antiplasmin-plasmin complexes with declines in plasminogen and alpha 2-antiplasmin levels provided evidence of activation of the fibrinolytic system. Elevated plasma levels of tissue plasminogen activator and von Willebrand factor reflected endothelial stimulation. Thus, even early in the course of Rocky Mountain spotted fever that is treated promptly, there is activation of platelets, coagulation pathways, and the fibrinolytic system. These changes may be related to endothelial perturbation, a major pathogenetic mechanism in the disorder. |
| تدمد: | 1533-4406 0028-4793 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::cd5b0d9380acb1acdfe15c09076c6a3fTest https://doi.org/10.1056/nejm198804213181603Test |
| رقم الانضمام: | edsair.doi.dedup.....cd5b0d9380acb1acdfe15c09076c6a3f |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15334406 00284793 |
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