[A case of hookworm infestation with dissociation values between FDP-E and FDP-D dimer].
We previously reported a five-year-old girl showing bleeding tendency and transient morphological and functional platelet abnormalities probably due to a hookworm, Necator Americanus, infestation. In this report, we describe the rarely accelerated fibrinogenolysis and/or fibrinolysis in this patient whose value of fibrinogen and/or fibrin degradation products(FDP) determined with an FDP-E assay was much higher than that determined with a D-dimer assay. Namely, on day-1 and day-13 of hospitalization, her D-dimer values were only 10 to 20% of the prospected values from FDP-E values. We speculated this phenomenon was induced by circulating protease(-like) agent(s) produced by hookworm, because the only slightly participation of plasmin and/or granulocyte elastase was evaluated by the determination of enzyme-inhibitor complexes. And the other possibility of fibrinogen degradation by blast- or tumor-associated protease was excluded by the clinical manifestations and primary disorders. In conclusion, we report a very rare case with the accelerated fibrinogenolysis and/or fibrinolysis in a patient with the hookworm infestation. We are interested in the mechanism that manifested the patient's bleeding tendency accompanied with morphological and functional platelet abnormalities.
Nakagoshi
R
R
Division of Clinical Pathology, Nagano Children's Hospital, Minami-azumi-gun, Nagano-pref. 399-8288.
Oguchi
H
H
Ishii
E
E
Ishikawa
S
S
Higuchi
Y
Y
Muramatsu
K
K
Okumura
N
N
Ogiso
Y
Y
D002675:Child, Preschool; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D005342:Fibrinolysis; D015801:Helminth Proteins / Q000502:physiology; D006470:Hemorrhage / Q000209:etiology; D006725:Hookworm Infections / Q000097:blood* / Q000150:complications; D006801:Humans
D005338:Fibrin Fibrinogen Degradation Products; D015801:Helminth Proteins; C036309:fibrin fragment D; C072054:fibrin fragment E-2