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Coagulation

Acquired bleeding disorders

Acute phase reaction


Reviewers: Kendall Crookston, M.D., Ph.D., University of New Mexico; Lizabeth Rosenbaum, MD, University of New Mexico; Julie Gober-Wilcox, M.D., Resident, University of New Mexico (see Reviewers page)
Revised: 8 October 2010, last major update September 2010
Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.

Definition / General
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● Many serum proteins become elevated due to illness, injury, inflammation or stress; also pregnancy
● Elevated levels return to normal after condition resolves

Terminology
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● Also called positive acute phase proteins

Etiology
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● In response to injury, neutrophils and macrophages secrete IL-1, IL-6, IL-8 and TNF-a into the bloodstream; liver then produces acute-phase reactants (Wikipedia, COPE)
● Production of other proteins is reduced ("negative" acute phase reactants)

Laboratory
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● Associated with increase in fibrinogen, factor VIII, vWF (up to 3x normal levels) and PAI-1 (up to 50x)
● Associated with decrease in PTT, decrease in protein S (due to binding to increased C4b)

End of Coagulation > Acquired bleeding disorders > Acute phase reaction


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