The Plasma Protamine Paracoagulation Test: Clinical and Laboratory Evaluation

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Abstract
Kidder, Wayne R., Logan, Laurence J., Rapaport, Samuel I., and Patch, Mary Jane: The plasma protamine paracoagulation test: Clinical and laboratory evaluation. Am. J. Clin. Pathol. 58: 675–686, 1972. The plasma protamine paracoagulation test has been evaluated as performed on citrated plasma at 37 C. with protamine sulfate in a final concentration of 0.09%. Instructions to prevent false positive results have been summarized. The test detected nascent clotting in vitro, fibrin monomer added to plasma in a final concentration of 0.05 mg. per ml., and early fibrin degradation products. During a period of 3 years, every patient we encountered with evidence of intravascular clotting by other criteria had an abnormal plasma protamine test result. Thus, a negative test constitutes strong evidence against a diagnosis of intravascular clotting. Patients were discovered with the combination of a clinical disorder predisposing to intravascular clotting, no or minimal abnormalities of other coagulation studies, and an abnormal plasma protamine test. The significance of this combination is discussed. The plasma protamine paracoagulation test should be included in the screening evaluation of the patient with suspected intravascular clotting.

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