ABSTRACT
In 124 patients with various types of malignancy, fpA and delta fpA were measured. In 35 of these patients the effect of heparin injection on fpA and delta fpA was studied. All patients were ambulant without clinical signs of venous thromboembolism or DIC and had not received cytostatic, anticoagulant, or radiotherapy recently. In about 75% of these patients, fpA was elevated, whereas in the blood of one third of the patients, both elevated fpA levels and accelerated delta fpA were detected. Eight of the 45 patients with accelerated delta fpA (and elevated fpA) presented laboratory signs of low-grade DIC. In the patients taken at random for heparin administration, delta fpA normalized upon heparin injection, whereas in the majority of patients, irrespective of the fpA-generation rate, fpA levels were not affected by "adequate" heparinization. These results indicate that (1) about 30% of the (selected) patients admitted to our cancer clinic present with evidence of intravascular thrombin activity and (2) in 70% of these patients fpA is generated, at least in part, at a site not accessible to heparin. In addition 95% of patients with active metastatic disease showed an elevated fpA, whereas 90% of cancer patients in remission and 80% of patients without metastasis had a normal fpA, indicating that fpA can potentially be used to estimate the spread and the activity of the malignant process.
Subject(s)
Fibrinogen/blood , Fibrinopeptide A/blood , Lymphoma/blood , Adolescent , Adult , Aged , Blood Coagulation/drug effects , Female , Heparin/pharmacology , Humans , Injections, Intravenous , Male , Middle Aged , Neoplasm StagingSubject(s)
Anticoagulants , Fibrinogen/blood , Fibrinopeptide A/blood , Pulmonary Embolism/drug therapy , Thrombophlebitis/drug therapy , Adult , Aged , Dose-Response Relationship, Drug , Female , Fibrin Fibrinogen Degradation Products , Heparin/administration & dosage , Heparin/therapeutic use , Humans , Infusions, Parenteral , Injections, Intravenous , Male , Middle Aged , Partial Thromboplastin Time , Pleural Effusion , Recurrence , Time FactorsABSTRACT
A case of severe haemorrhagic diathesis due to acquired deficiency of factor X (both immunologically and in procoagulant activity) is presented. The clinical and serological features of this case indicated mycoplasma pneumonial infection. Factor X in the peripheral blood did not appear to be influenced by administration of vitamin K, prothrombin-complex concentrate, fresh plasma or fresh whole blood. Circulating inhibitors of blood coagulation were absent and systemic amyloidosis could not be demonstrated. After 20 d, factor X spontaneously returned to normal. In view of the absence of other known causes of factor X deficiency, a possible relationship with mycoplasma pneumonial infection is suggested.
