Tissue factor pathway inhibitor in paediatric patients with nephrotic syndrome

Farida Ahmed Farid, Ahmed Abdullah Mohammed, Rania Saleh Beltagi, Hanaa Mohammed Afifi


Background. Tissue factor pathway inhibitor (TFPI) is an endogenous protease inhibitor that regulates the initiation of the extrinsic coagulation pathway by producing factor Xa-mediated feedback inhibition of the tissue factor/factor VIIa (TF/VIIA) catalytic complex.
Objectives. To evaluate plasma TFPI levels in paediatric patients with nephrotic syndrome (NS) and its correlation with disease activity.
Subjects and methods. Fifteen nephrotic patients in relapse (proteinuria >40 mg/m2/h, hypo-albuminaemia and oedema) before initiating steroid therapy (group I) and another 15 nephrotic patients in remission after withdrawal of steroid therapy (group II) were compared with 15 age- and sex-matched healthy children (group III). Besides clinical evaluation and routine laboratory investigations of NS, tissue factor pathway inhibitor levels in plasma were measured by enzyme-linked immunosorbent assay (ELISA).
Results. Plasma TFPI levels were higher in nephrotic patients during relapse (group I) and during remission (group II) (mean 102.53 (standard deviation (SD) 14.23) and 82.93 (SD 3.83) ng/ml, respectively) compared with those in the control group (62.40 (SD 7.53) ng/ml) (p<0.0001). In children with NS, plasma TFPI levels were higher during relapse (group I) compared with levels in remission (group II) (p<0.0001). There was a negative correlation between the plasma TFPI level and total protein and serum albumin, and a positive correlation between the TFPI level and the urinary protein/creatinine ratio (p<0.05).
Conclusion. NS was associated with an increased level of plasma TFPI in comparison with the control group, and the increase was more apparent in patients with active disease.

Authors' affiliations

Farida Ahmed Farid, professor of pediatrics

Ahmed Abdullah Mohammed, Associate professor of pediatrics

Rania Saleh Beltagi, Master degree in pediatrics

Hanaa Mohammed Afifi, professor of clinical pathology

Full Text



Tissue factor – nephrotic – pediatric – TFPI– thrombosis.

Cite this article

South African Journal of Child Health 2011;5(4):107.

Article History

Date submitted: 2011-10-08
Date published: 2011-12-06

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