A NEW THEORY OF INTERFERENCE WITH THE CLOTTING MECHANISM: THE COMPLEXING OF EUGLOBULIN WITH FACTOR V, FACTOR VII AND PROTHROMBIN

Abstract

Data are presented, supporting our recently postulated theory of interference with the clotting mechanism by unusual plasma globulins, based on the observation that such proteins have the ability to complex with clotting factors. The withdrawal of clotting factors as the result of the formation of such complexes may cause hemorrhagic phenomena. It is further postulated that the complex is reversible and that the released clotting factors would result in a thrombotic tendency. Thus, an explanation is possible for certain clinical hemorrhagic, thrombotic and thrombo-hemorrhagic diatheses. In case 1, macroglobulinemia with hemorrhages and a large thrombus, precipitation of the euglobulin from native plasma or reprecipitation from normal plasma reduced prothrombin and accelerator activities. These clotting factors were demonstrable in the euglobulin solution. In addition, in case 2, macroglobulinemia with hemorrhages, the total Factor V measured in the euglobulin and in the euglobulin-free plasma was greater than the amount originally measured in the plasma. This suggests in vivo combination of the euglobulin with Factor V. In case 3, myocardial and splenic infarctions, renal bleeding and purpura, the results suggested in vivo saturation of the euglobulin with Factor V. Factor V activity was not reduced by precipitation of the euglobulin. However, the activity measurable in the euglobulin was equal to that in the plasma.