Background : Anecdotal reports on the changes of tissue-type plasminogen activator(tPA), plasminogen activator inhibitor-1(PAI-1), von Willebrand factor(vWF) in
patients with disseminated intravascular coagulation(DIC) have not been constant. Development of DIC has been well documented in patients with hemorrhagic fever with
renal syndrome(HFRS), Tsutsugamushi disease, snake bite, acute promyelocytic leukemia. So we measured the levels of tPA, PAI-1 and vWF during different stages of DIC to elucidate the role of endothelial perturbation in the pathogenesis of those diseases.
Methods: Blood samples from 24 patients with DIC were collected daily during admission and once during convalescent period. tPA and PAI-1 were measured using
commercially available ELISA kits and vWF using rocket immunoelectrophoresis.
Results: tPA, PAI-1 and vWF in 9 serologically proven patients with HFRS had peaks during the 4-5th days of disease and decreased to normal since the 10th day of
disease. Ten Tsutsugamushi disease patients showed dual peaks during the first 14 days and the tPA peak preceded PAI-1 peak by 2-3 days. There had been only a slight
increase in tPA, PAI-1 and vWF in 2 patients with snake bite and 3 patients with acute promyelocytic leukemia.
Conclusion: In patients with HFRS and Tsutsugamushi disease plasma concentration of tPA, vWF and PAI-1 increased during developmental stage of DIC, and normalized
as DIC resolved.

Keywords: DIC, Tissue-type plasminogen activator, Plasminogen activator inhibitor-1, von Willebrand factor,