eMedicine Specialties > Hematology > Coagulation, Hemostasis, and Disorders

Antithrombin Deficiency: Multimedia

Author: Arun Rajan, MD, Clinical Fellow, Medical Oncology Branch, National Cancer Institute/National Institutes of Health
Coauthor(s): Sara J Grethlein, MD, Associate Dean for Graduate Medical Education, Professor, Department of Internal Medicine, Division of Hematology and Oncology, State University of New York Upstate Medical University; Rajalaxmi McKenna, MD, FACP, Southwest Medical Consultants, SC, Department of Medicine, Good Samaritan Hospital, Advocate Health Systems
Contributor Information and Disclosures

Updated: Oct 4, 2009

Multimedia

Antithrombin (AT) sites of action.
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Media file 1: Antithrombin (AT) sites of action.
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Antithrombin (AT) sites of action.

Antithrombin (AT) sites of action.

Antithrombin (AT) neutralizes the enzyme (IIa) by...
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Media file 2: Antithrombin (AT) neutralizes the enzyme (IIa) by forming a 1:1 stoichiometric complex (AT:IIa) between the arginine-serine sites of the 2 proteins. Binding of heparin to lysyl residues on AT results in a conformational change in AT, which makes it more available to bind thrombin (IIa), IXa, and Xa, thus markedly accelerating the rate of enzyme-inhibitor complex formation. AT also neutralizes XIa and XIIa.
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Antithrombin (AT) neutralizes the enzyme (IIa) by...

Antithrombin (AT) neutralizes the enzyme (IIa) by forming a 1:1 stoichiometric complex (AT:IIa) between the arginine-serine sites of the 2 proteins. Binding of heparin to lysyl residues on AT results in a conformational change in AT, which makes it more available to bind thrombin (IIa), IXa, and Xa, thus markedly accelerating the rate of enzyme-inhibitor complex formation. AT also neutralizes XIa and XIIa.

Cell surface–directed hemostasis (image ada...
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Media file 3: Cell surface–directed hemostasis (image adapted from Hoffman M, Monroe DM 3rd. A cell-based model of hemostasis. Thromb Haemost. 2001.). 38 Initially, a small amount of thrombin is generated on the surface of the tissue factor–bearing (TF-bearing) cell. Following amplification, the second burst generates a larger amount of thrombin, leading to fibrin (clot) formation.
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Cell surface–directed hemostasis (image ada...

Cell surface–directed hemostasis (image adapted from Hoffman M, Monroe DM 3rd. A cell-based model of hemostasis. Thromb Haemost. 2001.). 38 Initially, a small amount of thrombin is generated on the surface of the tissue factor–bearing (TF-bearing) cell. Following amplification, the second burst generates a larger amount of thrombin, leading to fibrin (clot) formation.

More on Antithrombin Deficiency

Overview: Antithrombin Deficiency
Differential Diagnoses & Workup: Antithrombin Deficiency
Treatment & Medication: Antithrombin Deficiency
Follow-up: Antithrombin Deficiency
Multimedia: Antithrombin Deficiency
References
Further Reading
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Further Reading

Related eMedicine Topics

Clinical Trials

Clinical Guidelines

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Keywords

antithrombin deficiency, AT deficiency, antithrombin III, AT III, ATIII, antithrombin 3, anticoagulation, anticoagulant, coagulation factors, hemostatic pathway, coagulation pathway, serine protease inhibitor, deep vein thrombosis, DVT, venous thrombosis, pulmonary embolism, PE, venous thromboembolism, VTE, thrombotic disease,

acute respiratory distress syndrome, ARDS, venoocclusive disease, veno-occlusive disease, VOD, bone marrow transplantation, BMT, chronic leg ulcerations, severe venous varicosities, postphlebitic syndrome, low molecular weight heparin, low-molecular-weight heparin, LMWH, pooled plasma treated with solvent-detergent, PLAS+SD, ATryn, Budd-Chiari syndrome, estrogen, hormone replacement therapy, HRT

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Contributor Information and Disclosures

Author

Arun Rajan, MD, Clinical Fellow, Medical Oncology Branch, National Cancer Institute/National Institutes of Health
Arun Rajan, MD is a member of the following medical societies: American Medical Association and American Society of Clinical Oncology
Disclosure: Nothing to disclose.

Coauthor(s)

Sara J Grethlein, MD, Associate Dean for Graduate Medical Education, Professor, Department of Internal Medicine, Division of Hematology and Oncology, State University of New York Upstate Medical University
Sara J Grethlein, MD is a member of the following medical societies: American Society of Hematology
Disclosure: Nothing to disclose.

Rajalaxmi McKenna, MD, FACP, Southwest Medical Consultants, SC, Department of Medicine, Good Samaritan Hospital, Advocate Health Systems
Rajalaxmi McKenna, MD, FACP is a member of the following medical societies: American Society of Clinical Oncology, American Society of Hematology, and International Society on Thrombosis and Haemostasis
Disclosure: Nothing to disclose.

Medical Editor

David Aboulafia, MD, Medical Director, Bailey-Boushay House; Clinical Professor, Department of Medicine, Division of Hematology, University of Washington
David Aboulafia, MD is a member of the following medical societies: American College of Physicians, American Medical Association, American Medical Directors Association, American Society of Hematology, Infectious Diseases Society of America, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Marcel E Conrad, MD, (Retired) Distinguished Professor of Medicine, University of South Alabama
Marcel E Conrad, MD is a member of the following medical societies: Alpha Omega Alpha, American Association for the Advancement of Science, American Association of Blood Banks, American Chemical Society, American College of Physicians, American Physiological Society, American Society for Clinical Investigation, American Society of Hematology, Association of American Physicians, Association of Military Surgeons of the US, International Society of Hematology, Society for Experimental Biology and Medicine, and Southwest Oncology Group
Disclosure: No financial interests None None

CME Editor

Rebecca J Schmidt, DO, FACP, FASN, Professor of Medicine, Section Chief, Department of Medicine, Section of Nephrology, West Virginia University School of Medicine
Rebecca J Schmidt, DO, FACP, FASN is a member of the following medical societies: American College of Osteopathic Internists, American College of Physicians, American Medical Association, American Society of Nephrology, International Society of Nephrology, National Kidney Foundation, Renal Physicians Association, and West Virginia State Medical Association
Disclosure: Abbott Grant/research funds Speaking and teaching; Genzyme Honoraria Consulting; Amgen Honoraria Speaking and teaching; Ortho Biotech Honoraria Speaking and teaching

Chief Editor

Emmanuel C Besa, MD, Professor, Department of Medicine, Division of Hematologic Malignancies, Kimmel Cancer Center, Thomas Jefferson University
Emmanuel C Besa, MD is a member of the following medical societies: American Association for Cancer Education, American College of Clinical Pharmacology, American Federation for Medical Research, American Society of Hematology, and New York Academy of Sciences
Disclosure: Nothing to disclose.

 
 
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