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Original Article
Brief Report
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Volume 333:494-497 August 24, 1995 Number 8
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Fatal Hemorrhage in a Patient with an Acquired Inhibitor of Human Thrombin
Albert R. La Spada, M.D., Ph.D., Bjørn S. Skålhegg, Ph.D., Ruth Henderson, B.S., Gottfried Schmer, M.D., Robert Pierce, M.D., and Wayne Chandler, M.D.

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Thrombin (factor IIa) is a serine protease that performs a number of functions in blood coagulation.1 Among its most important actions is converting fibrinogen into fibrin monomers, which polymerize to form the fibrin clot. Thrombin participates in the activation of factors V, VIII, and XIII, as well as of platelets.2 By binding to thrombomodulin on vascular endothelial cells, it forms a complex that activates protein C, thereby limiting the extent of an emerging clot.3 Cleavage of thrombin's inactive zymogen precursor, prothrombin (factor II), is required to generate functionally active thrombin.

Acquired inhibitors of certain coagulation factors are relatively common, but . . . [Full Text of this Article]

Case Report

Methods

Enzyme Immunoassays

Immunoblotting

Results

Discussion


Source Information

From the Departments of Laboratory Medicine (A.R.L.S., R.H., G.S., W.C.), Pharmacology (B.S.S.), and Pathology (R.P.), University of Washington Medical Center, Seattle.

Address reprint requests to Dr. La Spada at the Department of Laboratory Medicine, Box 357110, University of Washington Medical Center, 1959 N.E. Pacific St., Seattle, WA 98195.

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