ABSTRACT
We tested the hypothesis that complex irregular coronary lesions are "active" lesions and thus associated with ongoing fibrinolysis by measuring the degradation products of cross-linked fibrin (D-dimer) in 136 patients undergoing coronary arteriography. Blood samples obtained before catheterization were assayed by an enzyme linked immunosorbent assay (ELISA) using specific monoclonal antibodies for D-dimer particles. In the four groups with complex coronary morphologies (filling defects, extrinsic lesions with irregular borders and total occlusions with or without staining) the majority of patients (64%) had normal D-dimer levels. The incidence of abnormal D-dimer levels was not significantly higher in any of these four groups than in the two groups with normal coronaries or with smooth lesions. In the same patients, however, the clinical diagnosis was predictive of the presence of elevated D-dimer levels. These findings suggest that complex coronary lesions are often not associated with ongoing fibrinolysis and that endogenous fibrinolysis frequently ceases in the presence of persistent clot.
Subject(s)
Coronary Angiography , Coronary Disease/blood , Fibrin Fibrinogen Degradation Products/analysis , Antibodies, Monoclonal , Coronary Disease/diagnostic imaging , Enzyme-Linked Immunosorbent Assay , Female , Fibrinolysis , Humans , Male , Middle AgedABSTRACT
An unusual case of hairy cell leukemia is reported. The patient experienced severe bone pains at the sites of the bone lesions caused by infiltration by hairy cells documented histologically. The pains were resistant to various analgesics. Administration of corticosteroids resulted in prompt, full, and sustained response despite the persistence of bone lesions radiographically.
