Search
systemic fibrinolysis (fibrinolytic disorder)
Etiology:
1) chronic liver disease
2) primary amyloidosis
3) malignancy
Pathology: circulating activators of fibrinolysis
Laboratory:
1) in vitro clot lysis times are shorter than normal (in vitro clot lysis time is normal in DIC)
2) platelet count is generally normal
3) PT & aPTT may be prolonged (plasmin degrades factor V & factor VIII)
4) thrombin time is prolonged (due to fibrin degradation products or hypoalbuminemia)
5) see ARUP consult [2]
Management:
- antifibrinolytic agents
a) epsilon-aminocaproic acid (Amicar)
b) tranexamic acid
General
fibrinolysis
References
- Medical Knowledge Self Assessment Program (MKSAP) 11, American
College of Physicians, Philadelphia 1998
- ARUP Consult: Fibrinolytic Disorders
The Physician's Guide to Laboratory Test Selection & Interpretation
https://www.arupconsult.com/content/fibrinolytic-disorders