Acquired vitamin K-dependent carboxylation deficiency in liver disease.

Abstract

gamma-Carboxyglutamic acid residues on prothrombin are synthesized from glutamic acid on a prothrombin precursor in the liver through a vitamin K-dependent carboxylase. In the absence of vitamin K or in the presence of vitamin K antagonists, an inert form of prothrombin - abnormal prothrombin - circulates in the blood. We have developed specific immunoassays for native and abnormal human prothrombin. The prothrombin concentration in our normal subjects was 108 +/- 19 microgram per milliliter. The abnormal-prothrombin concentration varied over four orders of magnitude between the limits of detection in normal plasma and the level in patients with cirrhosis (0 to 5 microgram per milliliter), acute hepatitis (0 to 33 microgram per milliliter), or vitamin K deficiency (32 to 100 microgram per milliliter) and in those treated with sodium warfarin (12 to 65 microgram per milliliter). These studies indicate that abnormal prothrombin is not a component of normal plasma but appears in a variety of hepatic and nutritional disorders characterized by impaired hepatic vitamin-K-dependent carboxylation.

• Authors: R A Blanchard, B C Furie, M Jorgensen, S F Kruger, B Furie
• Journal: The New England journal of medicine (N Engl J Med) Vol. 305 Issue 5 Pg. 242-8 (Jul 30 1981) ISSN: 0028-4793 [Print] United States
• PMID: 6165889 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Epitopes
• Warfarin
• Prothrombin
• Ligases
• Carbon-Carbon Ligases
• glutamyl carboxylase

Topics

• Adult
• Aged
• Carbon-Carbon Ligases
• Epitopes
• Female
• Hepatitis (enzymology)
• Humans
• Ligases (deficiency)
• Liver (enzymology)
• Liver Cirrhosis (enzymology)
• Liver Diseases (blood, enzymology)
• Male
• Middle Aged
• Prothrombin (biosynthesis, immunology, isolation & purification)
• Prothrombin Time
• Vitamin K Deficiency (enzymology)
• Warfarin (adverse effects)