ProC® Global Assay in the Evaluation of Women with History of Severe Preeclampsia or HELLP Syndrome

• Published in: Clinical and applied thrombosis/hemostasis 2002-10, Vol.8 (4), p.319-324
• Main Authors: Heilmann, Lothar, Tempelhoff, Georg-Friedrich v., Pollow, Kuhnhart
• Format: Article
• Language: English
• Subjects: Adult; Anticoagulants; Biomarkers - blood; Blood Coagulation Tests - standards; Case-Control Studies; Female; Health risk assessment; HELLP Syndrome - blood; HELLP Syndrome - diagnosis; HELLP Syndrome - etiology; Humans; Lupus; Pre-Eclampsia - blood; Pre-Eclampsia - diagnosis; Pre-Eclampsia - etiology; Preeclampsia; Pregnancy; Protein C - analysis; Protein C - metabolism; Proteins; Reagent Kits, Diagnostic - standards; Sensitivity and Specificity; Thrombophilia - blood; Thrombophilia - diagnosis
• ISSN: 1076-0296; 1938-2723
• DOI: 10.1177/107602960200800403

Preeclampsia/HELLP syndrome has been associated with a high incidence of defects in the protein C pathway and increased anticardiolipin-antibodies/lupus anticoagulants. It is also apparent that thrombophilia is responsible for other pregnancy complications, such as recurrent spontaneous abortion, fetal growth restriction, intrauterine fetal death, and abruptio placentae. ProC® Global is a new global clotting assay designed to evaluate the abnormalities in the protein C anticoagulant pathway. It is based on the ability of endogenous activated protein C, generated by activation of protein C by Protac®, to prolong an activated partial thromboplastin time. A total of 61 patients with a history of severe preeclampsia or HELLP syndrome and 61 normal pregnant women (controls) were evaluated, 15 of whom had factor V Leiden mutation, 12 had protein C/S deficiency, 30 had a repeated lupus anticoagulants, and 27 increased anticardiolipin antibodies (ACA). All carriers of factor V Leiden mutation (N= 15) as well as all the patients with low activated protein C (APC) resistance ratio (N= 15) had a ProC® Global normalized ratio (NR) less than 0.80 (sensitivity 100%). Twenty-four patients positive for the lupus anticoagulants (LA) and 19 patients positive for ACA (> 5.0 IgG U/mL) had a ProC® Global NR less than 0.8, while six and eight, respectively, had a ProC® Global NR greater than 0.8 (sensitivity, 70%-80%). The detection of a reduced protein C/protein S activity (