The activity of leukocyte elastase (LE) and two markers for vascular endothelial cells (EC) dysfunction/lesion--von Willebrand factor (WF) and C-reactive protein (C-RP)--was determined in the blood plasma of 22 male patients, aged 23.7 +/- 5.5 years with attack-like schizophrenia (ALS) and 24 matched controls. A significant increase of WF, C-RP and LE was found in the patients compared to controls indicating EC dysfunction and/or lesion in ALS schizophrenia. Positive correlations between LE activity and WF concentrations as well as between WF and severity of clinical symptoms in ALS patients imply a vascular layer lesion of the blood-brain barrier.