EARLY MARKERS OF BLOOD-COAGULATION AND FIBRINOLYSIS ACTIVATION IN ARGENTINE HEMORRHAGIC-FEVER

Junin virus, an arenaviridae, is the etiological agent of Argentine he morrhagic fever. In addition to thrombocytopenia, patients present sev eral alterations in both the blood coagulation and the fibrinolytic sy stem, but diffuse intravascular coagulation could not be demonstrated. To investigate further the activation status of the two systems, leve ls of thrombin-antithrombin complexes (TAT). prothrombin fragment 1+2, protein C, total and free protein S, C4bBP, antithrombin III, t-PA, P AI-1 and D-dimer were measured. Fourteen patients with a confirmed dia gnosis of Argentine hemorrhagic fever were included in the study, 2 we re severe, 3 moderate and 9 mild clinical cases, but hemorrhages were slight throughout. Blood samples were collected for 6 consecutive days on admission and on remission. At admission TAT and F1+2 levels were increased in 13/14 patients, leaching 0.33 nM (0.06-0.87) and 2.16 nM (0.96-6.5), respectively. PC was low in 4 cases, fPS in 6 and tPS in 2 , whereas C4bBP and ATIII values were within normal range. t-PA and D- dimer levels were high in 11/14 patients, reaching 20 ng/ml (2.7-106) and 1660 ng/ml (877-3780) respectively, while PAI-1 was considerably i ncreased in the 2 severe cases and normal in the remain der. These res ults suggest low level though persistent process of blood coagulation and fibrinolysis activation in this viral hemorrhagic disease. We beli eve these abnormalities may lead to the well described bleeding manife stations in these patients.