Friday, September 13, 2019

AT-3

Q: Hemodialysis? (select one)

A) Increases the level of Antithrombin iii (AT-3)
B) Reduces the level of Antithrombin iii (AT-3)


Answer: B

AT-3 deficiency can be either hereditary or acquired. There are many clinical situations which reduce the level of AT-3 and consequently make it hard for effective anticoagulation with heparin. Some of such important clinical scenarios are:
  • Disseminated intravascular coagulation (DIC) 
  • Acute thrombosis 
  • Cirrhosis 
  • Nephrotic syndromes 
  • Extracorporeal membrane oxygenation (ECMO) 
  • Hemodialysis 
  • Trauma 
  • Preeclampsia and eclampsia

#hematology


References:

1. Mammen EF. Antithrombin: its physiological importance and role in DIC. Semin Thromb Hemost 1998; 24:19. 

2. Raya-Sánchez JM, González-Reimers E, Rodríguez-Martín JM, et al. Coagulation inhibitors in alcoholic liver cirrhosis. Alcohol 1998; 15:19. 

3. Kauffmann RH, Veltkamp JJ, Van Tilburg NH, Van Es LA. Acquired antithrombin III deficiency and thrombosis in the nephrotic syndrome. Am J Med 1978; 65:607. 

4. Alegre A, Vicente V, Gonzalez R, Alberca I. Effect of hemodialysis on protein C levels. Nephron 1987; 46:386. 

5. Weenink GH, Treffers PE, Vijn P, et al. Antithrombin III levels in preeclampsia correlate with maternal and fetal morbidity. Am J Obstet Gynecol 1984; 148:1092.

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