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

TADATAKA YAMADA, M.D.; PHILIP HARBER, M.D.; GEORGE W. PETTIT, Ph.D.; DAVID A. WING, Ph.D.; and CHARLES N. OSTER, M.D.
[+] Article and Author Information

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.


Frederick, Maryland


© 1978 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1978;88(6):764-768. doi:10.7326/0003-4819-88-6-764
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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.

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