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Plasminogen Activator Inhibitor 1 (PAI 1)


Definition


  • PAI 1, an inhibitor of plasminogen activation is synthesized in endothelial cells, in platelets, and by the liver.
  • Normal range: 0.0 " “22.0 IU/mL.

Use


  • This test may be used in rare cases with a tendency to thrombosis when no other cause is identified.

Interpretation


Decreased Values


  • Difficult to determine because the normal range can be as low as 0.0
  • Cases with an increased fibrinolytic tendency (bleeding, rapid dissolution of hemostatic clots)

Increased Values


  • May result in a tendency to arterial or venous thrombosis
  • Acquired: during acute thrombotic episodes, pregnancy, sepsis
  • Congenital: rare congenital elevations have been described

Limitations


  • This test is a biologic assay that is difficult to perform reproducibly.
  • The inhibitor has diurnal variations, with highest levels during morning hours (blood should be drawn fasting between 8 am and 12 pm).
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