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Antithrombin: A possible new prognostic marker and therapeutic tool for acute pancreatitis?

Donati V, Brogi E, Vetrugno L, Calamai I, Forfori F

The clinical manifestations of acute pancreatitis (AP) range from a local inflammatory process to the more severe form, associated with a systemic inflammatory response. Only patients with severe AP require intensive care admission. AP is characterized by the systemic activation of protease cascades. This inappropriate intracellular activation of digestive enzymes leads to the release of cytokines, activation of coagulation, tissue ischemia and tissue necrosis. All these factors play a vital role in the worsening of AP as well as in the development of associated extra-pancreatic complications. Haemostasis is strongly influenced by this inflammatory cascade; indeed, the pathways of inflammation and coagulation are intimately linked. Consequently, the multiorgan failure of severe acute pancreatitis is often associated with sepsis and disseminated intravascular coagulation