Antithrombin iii deficiency acquired - Altmeyers Encyclopedia

Definition
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In addition to congenital, primary antithrombin III deficiency, there are also acquired AT III deficiencies:

in the context of disseminated intravascular coagulation
for liver diseases
in the case of advanced liver parenchyma damage in the context of liver cirrhosis or toxic liver failure
after blood transfusion
in sepsis
in nephrotic syndrome (loss of AT-III as part of the protein loss in ascites and urine)
under continuous heparin therapy
after major surgery or severe trauma, burns.

In the case of an antithrombin III deficiency, the risk can be estimated by means of the so-called hypercoagulability index. Normally this is between 1 and 1.2. Hypercoagulability is present when the Hi value is < 0.7. Hypocoagulability is present when the Hi value is >1.2.
The activity of AT-III is pH dependent. The activity of antithrombin III decreases in an acidic environment.

For patients with both protein C and protein S deficiency, the incidence of thromboembolic events increases with age. At 28 years, the probability of suffering a thromboembolic event is 50%.
In case of a threatening deficiency, there is an indication for substitution with AT-III (e.g. Kybernin HS, Abinex, Atenativ, AT-III Imuno). 1 IU/kg increases the AT-III level by 1.0-1.5%.