Sir.—Parrish et al in their article in the April 1976 issue of the Journal entitled "Recurrent Arterial Thrombosis in Nephrosis" (130:428, 1976) has mentioned the corticosteroid effect on the pathogenesis of this occurrence.
Although they cited coagulation factor changes in nephrosis they did not indicate the elevation of factor VIII procoagulant activity related to corticosteroid treatment.1 I would also point out that factor VIII procoagulant activity is higher in the arterial blood than in the venous circulation,2 which might have a pathogenetic role in the arterial thrombosis in corticosteroid treated patients.