Factor XIII in a clinical material.

In 339 patients with various diseases factor XIII (FSF) was determined with the specific amine incorporation method of Lorand et al (1969). Normal values were found in patients with renal (216 patients) or liver diseases (33 patients), in 39 patients with recurrent deep venous thrombosis and in 17 children with congenital cyanotic heart disease. Low levels were found in patients with various conditions, such as sepsis, multiple fractures and combustio complicated by an abnormal proteolytic activity (fibrinolysis and/or activation of the coagulation system with signs of disseminated coagulation). No correlation was found between the FSF and the fibrinogen values or the levels of fibrin/fibrinogen degradation products (FDP). Low FSF values were found in 4 patients with erosive gastritis, with gastrointestinal bleedings and a local fibrinolytic activity in the gastric juice. Although the FSF must be very low (smaller than 1%) if it is to cause bleedings, the low levels in these patients with many other coexisting disturbances in the coagulation system and/or an increased fibrinolytic activity most probably contribute to the increased bleeding tendency in such patients.