Fibrin- and fibrinogen-related antigens in patients with venous disease and venous ulceration.
Abnormalities in systemic fibrinolysis have been implicated in the pathogenesis of venous ulceration. Patients with venous disease have a prolonged euglobulin lysis time and elevated plasma fibrinogen levels, yet little is known about the metabolism of fibrinogen and fibrin in such patients. In this study, we have used a technique that involves electrophoresis and densitometric analysis of captured fibrin-related antigens to measure the concentration and proportions of the individual fibrin and fibrinogen degradation products in patients with venous disease of the lower extremity. As a group, patients with venous disease had markedly elevated levels of total fibrin-related antigen and D-dimer, the terminal degradation product of cross-linked fibrin. Levels of D-monomer, the breakdown product of fibrinogen and non-cross-linked fibrin monomer, and a measure of fibrinogenolysis were normal in all patients. In patients with ulcers, the levels of D-dimer were disproportionately higher than expected from fibrin monomer levels. On an individual basis, significant elevations of D-dimer were present in six (55%) of the 11 patients with venous disease with ulcers and in three (43%) of the seven patients with venous disease without ulcers. We conclude that patients with venous disease have uniform evidence for enhanced fibrin formation, as evidenced by elevated levels of total fibrin-related antigen and D-dimer. This is regardless of whether the venous disease is accompanied by ulceration.
Falanga
V
V
Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, FL 33101.
Kruskal
J
J
Franks
J J
JJ
D000941:Antigens / Q000032:analysis*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005342:Fibrinolysis; D006801:Humans; D008297:Male; D014647:Varicose Ulcer / Q000097:blood / Q000276:immunology; D014648:Varicose Veins / Q000097:blood / Q000276:immunology* / Q000473:pathology
D000941:Antigens; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; C011468:fibrinmonomer; C023456:fibrinogen-related antigen