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A study was planed in 28 children affected with a nephrotic syndrome (group 1) in order to compare the total plasmatic progressive anti thrombin activity (Howie method) to the concentrations of three thrombin inhibitors, assayed by immunological methods : antithrombin III (AT III), α2 macroglobulin (α2 M), and al antitrypsin (α1 AT). The results were compared to those obtained in 21 normal children of the same age (group 2) and in 10 normal adults (age range : 25 - 50 yrs). The calibration curves were made with a pool of plasma from normal blood donors. The results (mean ± SD) and the comparison between groups 1 - 3 to group 2 are summarized.  A subgroup of 15 affected children which a low AT III level (less than 80%) was isolated (mean AT III = 51% ± 18) ; the mean of the total progressive anti thrombin activity was 124% ± 16. A significant negative relationship was found between AT III and α2 M level in the group 1 (r = -0.71, P &lt;0.01).  The high plasmatic level of α2 M (1) accounts for the increased progressive anti thrombin activity in all the affected children in spite of very low levels of AT III ; (2) could explain the absence of thrombotic events in this serie ; (3) suggests that the benefit of heparin therapy might be doubtfull since it has been recently reported that heparin inhibit the binding of α2 M to thrombin.

Comparison Of Progressive Antithrombin Activity And The Concentration Of Three Thrombin Inhibitors In Nephrotic Syndrome