Tovone X G, Rasamoelisoa J M, Rakotomalala S, Rabesiaka F, Rakotoarimanana D R, Ramialiharisoa A
Service de Réanimation, Centre Hospitalier de Soavinandriana, 101 Antananarivo, Madagascar.
Arch Inst Pasteur Madagascar. 1999;65(1-2):117-9.
Congenital afibrinogenemia is a rare autosomal recessive disease caused by markedly reduced or absent synthesis of fibrinogen. Consanguinity is common in affected family. Clinical manifestations range to minimal or moderate bleeding to catastrophic haemorrhage. Bleedings are often post-traumatic, sometimes spontaneous. Diagnosis is established by laboratory tests presenting trace or absence of fibrinogen. Substitutive treatment with fibrinogen concentrates or fresh frozen plasma is used. The authors reported the case of a 41-year-old male with congenital afibrinogenemia with fatal spontaneous cerebral haemorrhage. Diagnosis was made upon history, bleeding history, clinical examination, blood coagulation tests and radiography. Cerebral haemorrhage must be suspected in any patient presenting blood coagulation disorders with bleeding history. Drug therapy must be installed immediately and continued before obtention of specific radiology images which are often late in relation to clinical signs.
先天性无纤维蛋白原血症是一种罕见的常染色体隐性疾病,由纤维蛋白原合成显著减少或缺乏所致。近亲结婚在受累家庭中很常见。临床表现从轻微或中度出血到灾难性大出血不等。出血常发生于创伤后,有时为自发性出血。通过实验室检查发现纤维蛋白原微量或缺乏来确诊。采用纤维蛋白原浓缩物或新鲜冰冻血浆进行替代治疗。作者报告了一例41岁男性先天性无纤维蛋白原血症患者发生致命性自发性脑出血的病例。根据病史、出血史、临床检查、凝血试验及影像学检查做出诊断。对于任何有出血史且存在凝血障碍的患者,都必须怀疑有脑出血。必须立即开始药物治疗,并在获得往往相对于临床症状出现较晚的特定影像学图像之前持续用药。