Two sisters born from a nonconsanguineous marriage were found to have congenital factor XIII deficiency. In the electroimmunoassay system, using an anti-subunit S antiserum, two distinct peaks or rockets were seen in normal plasma and serum whereas only one peak was present in the propositae plasma or serum. In the bidimensional immunoelectrophoresis system, using the anti-subunit S antiserum, two major peaks were seen in normal plasma whereas only one peak was seen in the propositae plasma. Using an anti-subunit A antiserum no peak or precipitate was seen in our propositae in the electroimmunoassay or in the bidimensional immunoelectrophoresis systems. Both the parents and the children of our two propositae showed a normal coagulation pattern. Therefore, the heredity appears to be autosomal recessive. These data indicate that the defect is characterized by a normal factor XIII subunit S (support) and a lack of factor XIII subunit A (activity)
23 patients with hemophilia B have been investigated by means of several immunological
methods. 16 patients (69.9%) had no detectable factor XI antigen. Five had a normal
factor IX antigen and the electrophoretic mobility of this abnormal factor IX was similar to
that of its normal counterpart. One of these five patients had hemophilia B(m), since ox brain
thromboplastin clotting time was severely prolonged. The remaining two patients had reduced
or decreased factor IX antigen. Several patients showed a slight prolongation of ox brain
thromboplastin time due to an associated slight factor VII deficiency. On the basis of these
results, a tentative classification of hemophilia B into five variants is proposed, namely: hemophilia
B-, or with no factor IX antigen; hemophilia B+, or with normal factor IX antigen;
hemophilia B(ra), or with reduced factor IX antigen; hemophilia B(m), or with normal factor IX
antigen and severely prolonged ox brain thromboplastin; hemophilia B, usually B-, with associated
mild factor VII defect. A complete evaluation of the hemophilia B patients is feasible
only by means of a battery of tests, namely : factor IX activity assay, factor IX antigen determination,
ox brain thromboplastin clotting time, factor VII activity assay.
The immunologic concentration of two abnormal antithrombins III (AT III), namely antithrombin III Padua (AT III Padua) and antithrombin III Padua2 (AT III Padua2) and the kinetics of the reaction of these two ATs III with an anti AT III antiserum was investigated by means of a laser nephelometer. The immunologic concentration of these two AT III both in presence (0.2 IU/mL) or absence of heparin was normal. On the contrary, the analysis of kinetics behavior demonstrated that AT III Padua is radically different from pooled normal plasma both in presence or in absence of heparin. This was not the case for AT III Padua2, which showed no difference from pooled normal plasma regardless of the presence or absence of heparin. Both abnormal antithrombins III reached the plateau of the reaction at about the corresponding value of pooled normal plasma, indicating a normal antigen level. These experimental data were analyzed by means of a computer (Apple II 48 RAM) programmed to solve a four unknowns equation (Rodbard's equation). This analysis showed that the time needed to reach half of the maximum voltage, i.e., the parameter C, which is expressed in minutes, is clearly longer in the case of AT III Padua samples (heparinized or not) as compared with pooled normal plasma. Moreover, the time at which the maximum rate was reached was also longer. On the contrary, in the case of AT III Padua2 there is no difference from pooled normal plasma. These data confirm the view that a different kind of defect is present in these two AT III abnormalities.(ABSTRACT TRUNCATED AT 250 WORDS)
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