Increased levels of tissue plasminogen activator with a low plasminogen activator inhibitor-1 in a patient with postoperative bleeding.
Recurrent postoperative bleeding in a previously healthy man with a moderate prolongation of PT and PTT which did not correct with vigorous fresh-frozen plasma infusion was identified as a unique abnormality of the fibrinolytic system: a combination of an excess of tissue plasminogen activator (t-PA) at 300% of normal activity accompanied by a concurrent deficiency of plasminogen activator inhibitor-1 activity (PAI-1) of 10-20% of normal activity. This observation underscores the potentially important regulatory role of PAI-1 in the degree to which clinical manifestations of bleeding tendencies may occur in patients in whom an excess amount of t-PA is expressed.
Stankiewicz
A J
AJ
Brown University Program in Medicine, Rhode Island Hospital, Providence 02903.
Crowley
J P
JP
Steiner
M
M
D000368:Aged; D006470:Hemorrhage / Q000503:physiopathology*; D006801:Humans; D008297:Male; D010314:Partial Thromboplastin Time; D015849:Plasminogen Inactivators / Q000097:blood*; D010976:Platelet Count; D011183:Postoperative Complications; D011517:Prothrombin Time; D013733:Testicular Diseases / Q000601:surgery; D006848:Testicular Hydrocele / Q000601:surgery; D010959:Tissue Plasminogen Activator / Q000097:blood*
D015849:Plasminogen Inactivators; D010959:Tissue Plasminogen Activator