A patient with cirrhosis of liver has the following coagulation parameters. Platelet count 2,00,000, Prothrombin time 25s/12s, Activated paial thromboplastin time 60s/35s and thrombin time 15s/15s. Which of the following laboratory finding can also be seen in this patient?
In patients with chronic liver disease the levels of vitamin K dependent coagulation factors are reduced (II,VII,IX,X) leading to increase in PT and PTT. The levels of D dimer is usually normal and factor VIII levels are not affected. Factor VII has a sho half life of 6 hours and is most reflective of hepatocellular damage. The levels of fibrinogen are both quantitatively and qualitatively altered, low levels of fibrinogen is due to decreased synthesis and increased consumption. Antithrombin III is a serine protease inhibitor produced in the liver, it acts as an anticoagulant by directly binding and inactivating serine protease, above all thrombin, but also factors IXa, Xa and XIa. Ref: Liver Disease in Children edited by Frederick J. Suchy, page 119, Postgraduate Haematology By Anthony R. Green page 844.
D-dimer will be normal
Fibrinogen will be
AT III will be high
Protein C will be elevated