Factors XI and XII are low in subjects with liver disease |
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Authors: | Dr Irwin R Walker MBBS FRCP FRACP Ruth A Milner BSc MIS Marilyn A Johnston ART Carol A Rand BSc Peter B Neame MD FRCP Jack Hirsh MD FRACP FRCP |
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Institution: | 1. Departments of Medicine, Pathology and Clinical Epidemiology and Biostatistics, McMaster University, 1200 Main St. West, L8N 3Z5, Hamilton, Ontario, Canada
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Abstract: | We prospectively measured levels of factors XI and XII in parallel with other coagulation factors in 39 unselected patients with liver disease and in 20 control subjects. Mean levels of factors XI and XII in subjects with liver disease were significantly reduced, being 58% and 61%, respectively, compared with 100% and 94% in controls. Reductions in levels of factors XI and XII were most pronounced in those subjects with low serum albumin. The partial thromboplastin time (APTT) reflected low levels of either factor XI or XII and was most prolonged when both were low, but cause and effect was not demonstrated. Low levels of these factors may explain previous reports of poor response of APTT to infusions of prothrombin complex concentrates. Finally, these low levels strongly suggest that factors XI and XII are produced in the liver. |
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