Stroke in a young adult with familial plasminogen disorder.
BACKGROUND
We report a new plasminogen disorder detected in a 29-year-old man with a cerebellar infarct. To our knowledge, plasminogen disorders have not been previously linked with stroke.


METHODS
Tests for well-recognized causes of stroke were negative. However, a screening hypercoagulation profile indicated low functional levels of plasminogen activity. Immunologic plasminogen (Laurell technique) was 64% of normal (normal level, 80-130%). The rate of plasmin generation induced by adding urokinase to plasma was also low. Plasminogen activator, free protease, and alpha 2-plasmin inhibitor levels were normal. Family studies detected a similar plasminogen abnormality in the patient's mother and 9-year-old son, both of whom are asymptomatic.


CONCLUSIONS
Our patient shows a congenital, heterozygous, functionally abnormal plasminogen. Although the exact relationship to stroke is unclear, we suggest screening young patients with unexplained stroke for plasminogen defects using commercially available assay systems.
Furlan
A J
AJ
Department of Neurology, Cleveland Clinic Foundation, OH 44106.
Lucas
F V
FV
Craciun
R
R
Wohl
R C
RC
D000328:Adult; D001778:Blood Coagulation Disorders / Q000378:metabolism*; D002531:Cerebellum / Q000098:blood supply*; D002561:Cerebrovascular Disorders / Q000378:metabolism*; D006801:Humans; D007238:Infarction / Q000378:metabolism*; D008297:Male; D010375:Pedigree; D010958:Plasminogen / Q000235:genetics / Q000378:metabolism*
D010958:Plasminogen