Fibrinolysis syndrome

Fibrinolysis syndrome is a medical condition characterized by the excessive breakdown of fibrin in the blood, leading to increased bleeding and clotting disorders. This syndrome is often associated with various underlying conditions and can be a significant complication in patients with certain diseases or undergoing specific treatments.

Pathophysiology

Fibrinolysis is a normal physiological process that prevents blood clots from growing and becoming problematic. It involves the enzymatic breakdown of fibrin in blood clots. The primary enzyme responsible for fibrinolysis is plasmin, which is activated from its precursor, plasminogen, by tissue plasminogen activator (tPA) and urokinase. In fibrinolysis syndrome, this process becomes dysregulated, leading to excessive fibrin degradation and a propensity for bleeding.

Causes

Fibrinolysis syndrome can be triggered by various conditions, including:

• Disseminated intravascular coagulation (DIC)
• Liver disease
• Sepsis
• Trauma
• Certain malignancies, such as acute promyelocytic leukemia
• Use of thrombolytic therapy

Symptoms

The symptoms of fibrinolysis syndrome can vary depending on the underlying cause but often include:

• Uncontrolled bleeding
• Easy bruising
• Hematuria (blood in urine)
• Gastrointestinal bleeding
• Prolonged bleeding from cuts or injuries

Diagnosis

Diagnosis of fibrinolysis syndrome typically involves a combination of clinical evaluation and laboratory tests. Key diagnostic tests include:

• D-dimer test
• Fibrin degradation products (FDPs)
• Prothrombin time (PT) and activated partial thromboplastin time (aPTT)
• Complete blood count (CBC)
• Liver function tests

Treatment

The treatment of fibrinolysis syndrome focuses on addressing the underlying cause and managing symptoms. Therapeutic approaches may include:

• Administration of antifibrinolytic agents such as tranexamic acid or aminocaproic acid
• Blood transfusions
• Supportive care for underlying conditions
• Use of fresh frozen plasma or cryoprecipitate in severe cases

Prognosis

The prognosis of fibrinolysis syndrome depends on the underlying cause and the promptness of treatment. Early diagnosis and appropriate management are crucial for improving outcomes.

Related Pages

• Coagulation
• Hemostasis
• Thrombosis
• Hemophilia
• Von Willebrand disease