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One of the most constant abnormal laboratory results in chronic liver diseases is the low antithrombin III /AT-III/ acitivity measured in a properly sensitive system. Two functional assays have been used in our laboratory: /a/ coagulation test based on the progressive neutralization of thrombin with clotting time determinations in the presence of small amount of heparin and without it; results were expressed as plasma AT-III index or PAT-value, and /b/ amidolytic method on synthetic chromogenic substrate.  Results of the last years can be summarized as follows: /1/ the measurement of AT-III in liver diseases/more than 300 cases, mostly cirrhosis/ is of diagnostic significance: a high index, hence a low AT-III activity, particularly in a system containing heparinized plasma is much more characteristic in cases of liver cirrhosis than results of other conventional clotting tests /prothrombin time, partial thromboplastin time, plasma fibrinogen and FDP level/; /2/ the observations may have theoretical importance, furnishing additional data on the pathophysiological role of AT-III and providing the first and strong evidence for the adverse effect of heparin in thrombin-antithrombin interaction. The level of this natural anticoagulant synthetized in liver may be reduced by increased consumption accompanying disseminated intravascular coagulation. Though it is not frequent, it must be taken into consideration, first of all in active chronic hepatitis.

Antithrombin III In Chronic Liver Diseases