EVALUATION OF PRO-C GLOBAL FOR IDENTIFICATION OF DEFECTS IN PROTEIN C/S ANTICOAGULANT PATHWAY
Abstract
Background: Detection of protein C and S deficiency forms a major investigation in thelaboratory evaluation of thrombophilia screening. It has key role in the diagnosis of protein C and
S deficiency. The objective of this study is to determine the utility of ProC Global as a screening
test for identifying the defects of protein C and S anticoagulant pathways. Methods: Two
Hundred patients with venous thromboembolism were studied at the Department of Haematology,
Armed Forces Institute of Pathology, Rawalpindi, from October 2004 to March 2006. ProC Global
test (Dade Behring Diagnostics) was performed and was followed up by protein C and S assays.
ProC Global is an activated partial thromboplastin time based assay in which Protac (snake venom
from Aghistroden contortrix) is used for activation of the endogenous protein C of the plasma
sample. The protein C activation time in the presence of the activator was set in relation to a
parallel determination of PCAT/O with addition of a buffer instead of activator reagent. The ratio
PCAT: PCAT/O was transformed in normalized ratio by relating them to a calibrator. Control
plasma for normal range and ProC control plasma for pathological range (Dade Behring
Diagnostics) were assayed in each run for quality control. Results: A total of 200 patients, 132
(66%) males and 68 (34%) females with age ranging from 1 to 68 years were studied. ProC Global
was positive in 29/200 (14.5%) patients. ProC Global was found to be 86% sensitive, 94% specific
and its overall efficiency turned out to be 94%. Conclusion: Pro-C Global can be used effectively
as a screening test to detect abnormalities in protein C and S anticoagulant pathways.
Keywords: Protein C deficiency, Protein S deficiency, Thrombophilia
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