DEMONSTRATION OF A CIRCULATING ANTICOAGULANT IN PLASMA THROMBOPLASTIN ANTECEDENT DEFICIENCY

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Abstract
A patient with plasma thromboplastin antecedent (PTA) deficiency was inhibitory to correction of hemorrhagic diathesis by plasma or whole blood transfusion. The usual techniques of studying circulating anticoagulant, i.e., effect on the whole blood clotting time, serum prothrombin time, and plasma recalcification time, of mixtures of patient''s and normal whole blood or serum or adsorbed plasma did not reveal the presence of an anticoagulant. Since there is evidence to indicate that the mechanism of production of anticoagulants in primary hemorrhagic disorders such as hemophilia and PTC deficiency, may be an immunologic one, it was decided to apply the technique of incubation of various mixtures of patient''s and normal reagents in the thromboplastin generation test (TGT). After 4 hours of incubation of the individual reagents and their mixtures, it was evident that an anticoagulant directed against PTA was demonstrable in the TGT. It was further shown that the inhibitor was not directed against either antihemophilic globulin or plasma thromboplastin component.