Activation of the Kallikrein-Kinin System in Rocky Mountain Spotted Fever

  1. TADATAKA YAMADA, M.D.;
  2. PHILIP HARBER, M.D.;
  3. GEORGE W. PETTIT, Ph.D.;
  4. DAVID A. WING, Ph.D.; and
  5. CHARLES N. OSTER, M.D.
  1. Frederick, Maryland

    Abstract

    Activation of the kallikrein-kinin system, as indicated by increased plasma kallikrein and depleted plasma kininogen, prekallikrein, and kallikrein inhibitor, was observed in five patients with Rocky Mountain spotted fever. Four of the patients had petechial rashes characteristic of vasculitis. Three patients had alterations in coagulation consistent with disseminated intravascular coagulation, although no hemorrhagic syndrome was found. Our data, along with the known physiologic actions of kinins, suggest a possible role for the kallikrein-kinin system in the pathophysiology of vasculitis, disseminated intravascular coagulation, circulatory shock, and other complications of infection with Rickettsia rickettsii.

    Article and Author Information

    • ▸From the United States Army Medical Research Institute of Infectious Diseases; Frederick, Maryland.

    • The views of the authors do not purport to reflect the positions of the Department of the Army or the Department of Defense.

    • ▸Requests for reprints should be addressed to Tadataka Yamada, M.D.; Division of Gastroenterology, UCLA School of Medicine; Los Angeles, CA 90024.

      • Received July 29, 1977.
      • Accepted February 17, 1978.
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    1. Ann Intern Med June 1, 1978 vol. 88 no. 6 764-768
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