Protein c deficiency (acquired) - Altmeyers Encyclopedia

Synonym(s)

Acquired protein C deficiency; Protein C deficiency

Definition
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Acquired deficiency or lack of protein C.

Classification
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In addition to congenital protein C deficiencies, there are also a number of exogenously caused protein C deficiencies:

Coumarin therapy
Asparaginase therapy in the context of leukemia treatment
in liver diseases, e.g. Budd-Chiari syndrome or venooclusive syndrome (VOD)
for consumption coagulopathy
after operations following polytrauma
for progressive renal insufficiency
for vitamin K deficiency
in sepsis
post-infectious (cloinical) symptoms 10-14 days after the first infection infections (e.g. varicella)
with massive blood loss
for chronic inflammatory bowel disease.

The protein C concentration can be increased in:

pregnancy
ingestion of ovulation inhibitors
diabetes mellitus
Nephrotic syndrome.

Etiopathogenesis
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Together with a coenzyme, protein S, the protein C/protein S system is activated via the thrombin-thrombomodulin complex in a negative feedback reaction and inhibits the activated factors V and VIII (Va, VIIIa) by proteolytic cleavage. Thus, the protein C/protein S system plays a key role in the inhibition of hemostasis, because with this action it controls the activation of factor X to Xa and thus of prothrombin to thrombin.