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Protein C

Vitamin K-dependent, protein C is produced in the liver and circulates in the plasma. It acts as a potent anticoagulant by suppressing activated factors V and VIII. Deficiencies of protein C may be acquired or congenital.

If a deficiency of protein C is identified, further immunologic tests may be needed to determine the type of deficiency. Identifying the role of protein C deficiency in idiopathic venous thrombosis may help prevent thromhucmbolism.

Purpose

• To investigate the cause of otherwise unexplained thrombosis and to establish inheritance patterns.

Patient preparation

• Explain to the patient that this test evaluates blood clotting.
• Tell him that a blood sample will be taken. Explain who will perform the venipuncture and when.
• Reassure him that drawing a blood sample will take less than 3 minutes.
• Explain that he may feel slight discomfort from the tourniquet pressure and the needle puncture.
• Inform the patient that food or fluids needs not be restricted before the test.
• If the patient is receiving anticoagulant therapy, note this on the laboratory slip.

Procedure and posttest cane

• Perform a venipuncture. Collect a 3-ml sample in a blue-top vacuum specimen tube or in a special syringe with anticoagulant provided by the laboratory.
• If a hematoma develops at the venipuncture site, apply warm soaks.

Precautions

• Avoid excessive probing during venipuncture.
• Completely fill the collection tube, and invert it several times to mix the sample and anticoagulant thoroughly; handle the sample gently.
• Send the sample to the laboratory immediately.

Reference values

The normal range is 70% to 130%.

Abnormal findings

Rare, homozygous protein C deficiency is characterized by rapidly fatal thrombosis in the perinatal period, a condition known as purpura fulminans.

The more common heterozygouS deficiency is associated with genetic susceptibility to venous thromboembolism before age 30 and continuing throughout life. The patient may require long term treatment with warfarin therapy or protein C supplements from plasma

Interfering factors

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• Hemolysis due to excessive probing at the venipuncture site or to rough handling of the sample.
• Anticoagulant therapy.

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