Profound imbalance of pro-fibrinolytic and anti-fibrinolytic factors (tissue plasminogen activator and plasminogen activator inhibitor type 1) and severe bleeding diathesis in a patient with cirrhosis
| Autor: | Deane F. Mosher, Bradford S Schwartz, Brad S. Kahl |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Male
medicine.medical_specialty Cirrhosis medicine.medical_treatment Liver transplantation Hemorrhagic Disorders Gastroenterology chemistry.chemical_compound Liver Cirrhosis Alcoholic Internal medicine Plasminogen Activator Inhibitor 1 Fibrinolysis medicine Humans business.industry T-plasminogen activator Hematology General Medicine Middle Aged medicine.disease Liver Transplantation Bleeding diathesis Transplantation chemistry Tissue Plasminogen Activator Plasminogen activator inhibitor-1 Immunology business Plasminogen activator |
| Zdroj: | Blood Coagulation & Fibrinolysis. 14:741-744 |
| ISSN: | 0957-5235 |
| DOI: | 10.1097/00001721-200312000-00008 |
| Popis: | A 49-year-old male with alcoholic cirrhosis suffered several spontaneous, life-threatening, deep muscle bleeding episodes. Laboratory evaluation indicated excessive fibrinolysis with low plasminogen, low alpha2-antiplasmin, undetectable plasminogen activator inhibitor type 1 (PAI-1) activity, high tissue plasminogen activator (t-PA) activity and high t-PA antigen. Treatment with oral anti-fibrinolytic agents prevented further bleeding episodes. Decompensated cirrhosis eventually necessitated orthotopic liver transplantation. Post-operatively, the patient did not require oral anti-fibrinolytic agents, and there were no significant bleeding events. Circulating PAI-1 activity, t-PA activity and antigen normalized by 3 months post transplant. In short, the profound bleeding diathesis, as well as the imbalance in t-PA and PAI-1 levels, corrected after liver transplantation. Recognition of such patients is important, because the bleeding diathesis is an indication rather than a contraindication for orthotopic liver transplantation. |
| Databáze: | OpenAIRE |
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