Kraiem Imen, Guermazi Sami, Ben Abid Héla, Meddeb Balkis
Laboratoire d'Hématologie, Institut Pasteur de Tunis, Tunisie.
Tunis Med. 2010 Oct;88(10):757-60.
Congenital dysfibrinogenemia is a functional disorder of the fibrinogen that represents a rare cause of thrombophilia.
To report a Tunisian case of the association dysfibrinogenemia and thrombosis.
A woman with inherited dysfibrinogenemia associated with mild tendency to bleeding experienced a deep vein thrombosis of the lower-extremity at 26 years of age and a fatal pulmonary embolism a few years later. Paradoxically coagulation function of fibrinogen was markedly altered in vitro with a significantly prolonged prothrombin time, activated partial thromboplastin time and thrombin time, a functional fibrinogen level that was undetected and a severely impaired fibrin polymerisation. The thromboembolic events in the patient could be related to dysfibrinogenemia since the main causes of thrombophilia were excluded.
Although it is rare, this cause of thrombophilia must not be misdiagnosed, systematic measuring of prothrombin time, activated partial thromboplastin time and functional fibrinogen might be helpful.
先天性纤维蛋白原异常血症是一种纤维蛋白原功能障碍,是导致易栓症的罕见原因。
报告一例突尼斯纤维蛋白原异常血症与血栓形成相关的病例。
一名患有遗传性纤维蛋白原异常血症且有轻度出血倾向的女性,26岁时发生下肢深静脉血栓形成,几年后发生致命性肺栓塞。矛盾的是,纤维蛋白原的凝血功能在体外显著改变,凝血酶原时间、活化部分凝血活酶时间和凝血酶时间明显延长,功能性纤维蛋白原水平未检测到,纤维蛋白聚合严重受损。由于排除了易栓症的主要原因,患者的血栓栓塞事件可能与纤维蛋白原异常血症有关。
尽管这种易栓症病因罕见,但不应误诊,系统检测凝血酶原时间、活化部分凝血活酶时间和功能性纤维蛋白原可能会有帮助。