Plasma antithrombin III activity and concentration were measured simultaneously on COBAS MIRA-S by colorimetry using a synthetic substrate and by immunoturbidimetry, respectively, in normal subjects (n = 30), in patients with liver disease (n = 37), and in those with thrombosis (n = 76). The activity/concentration ratio of plasma antithrombin III, in which concentration was represented as the ratio to the mean concentration for normal, was evaluated in each group. Results showed that the ratio was significantly lower in patients with liver diseases (0.76 +/- 0.18, mean +/- SD, p < 0.01) and in thrombotic patients (0.89 +/- 0.18, p < 0.01) than that in normal (1.07 +/- 0.06), demonstrating the predominance of antithrombin III molecules with low activity in the former groups. This simple and rapid (< 10 min) method is applicable for detecting such the constitutional change in plasma antithrombin III.