title: Clinical failure of streptokinase due to an unsuspected high titer of antistreptokinase antibody.
abstract: Neutralization of streptokinase by an unsuspected high titer of antistreptokinase antibody prevented activation of the fibrinolytic system and induction of a lytic state in a 62 year old man with an acute inferior myocardial infarction. There was no decrease in serum fibrinogen, minimal decrease in serum plasminogen and only a small increase in serum fibrin degradation products after intravenous administration of 1.5 million units of streptokinase. A high titer of antistreptokinase antibody, sufficient to neutralize 1.5 million units of streptokinase, was demonstrated by semiquantitative counterelectrophoresis . There was no clinical evidence of coronary artery reperfusion, and coronary angiography confirmed complete occlusion of the left circumflex artery.
mesh_terms: D000907:Antibodies, Bacterial / Q000032:analysis*; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000188:drug therapy* / Q000276:immunology; D010958:Plasminogen / Q000032:analysis; D013300:Streptokinase / Q000627:therapeutic use*
chemical_list: D000907:Antibodies, Bacterial; D005338:Fibrin Fibrinogen Degradation Products; C014338:antistreptokinase; D005340:Fibrinogen; D010958:Plasminogen; D013300:Streptokinase