Gafter U, Mandel E M, Weiss S, Djaldetti M
Acta Haematol. 1976;56(6):355-9. doi: 10.1159/000207962.
A 51-year-old male with acute lymphoblastic leukemia whose course was complicated by primary fibrinolysis and spontaneous rupture of the spleen is described. The patient was treated with various drug combinations: vincristine and prednisone, later by cytosine arabinoside and finally by prednisone, methotrexate and 6-mercaptopurine. Four months after the diagnosis he developed epistaxis and petechiae. The coagulation tests were compatible with primary fibrinolysis and he responded to treatment with epsilon-aminocaproic acid (EACA). One month and a half later he developed again epistaxis, ecchymoses, splenomegaly and an acute abdomen. The coagulation tests revealed primary fibrinolysis. The operation revealed a ruptured spleen. After splenectomy the treatment with EACA was continued and, despite an improvement in the coagulation tests, the patient died.
本文描述了一名51岁的急性淋巴细胞白血病男性患者，其病程并发原发性纤维蛋白溶解症和脾脏自发性破裂。患者接受了多种药物联合治疗：长春新碱和泼尼松，随后是阿糖胞苷，最后是泼尼松、甲氨蝶呤和6-巯基嘌呤。诊断后四个月，他出现鼻出血和瘀点。凝血检查结果与原发性纤维蛋白溶解症相符，他对ε-氨基己酸（EACA）治疗有反应。一个半月后，他再次出现鼻出血、瘀斑、脾肿大和急腹症。凝血检查显示原发性纤维蛋白溶解症。手术发现脾脏破裂。脾切除术后继续使用EACA治疗，尽管凝血检查有所改善，但患者仍死亡。
