Acquired dysfibrinogenemia secondary to multiple myeloma.
Abnormal coagulation properties indicative of a dysfibrinogen were found in the plasma of a 72-year-old male with multiple myeloma (IgGkappa, stage IIIA). The patient had high paraprotein concentration (85.75 g/l) and prolonged thrombin time (76.8 s), activated partial thromboplastin time (39.5 s), prothrombin time (23.5 s) and reptilase time (72.0 s). The fibrinogen level was increased. The fibrin polymerization induced by both thrombin and reptilase was impaired. Scanning electron microscopy revealed abnormal clot morphology. After six months of treatment, the paraprotein level decreased (19.48 g/l) and coagulation normalized as well as fibrin polymerization and fibrin clot morphology. It was found that the paraprotein interacts with the gamma-chain of fibrinogen. Acquired dysfibrinogenemia associated with multiple myeloma was diagnosed in the 72-year-old patient.
Institute of Hematology and Blood Transfusion, Praha, Czech Republic. kotlinr@uhkt.cz
Roman
R
Kotlín
Alzbeta
A
Sobotková
Tomás
T
Riedel
Peter
P
Salaj
Jirí
J
Suttnar
Zuzana
Z
Reicheltová
Pavel
P
Májek
Tarek
T
Khaznadar
Jan E
JE
Dyr
D000347:Afibrinogenemia / Q000209:etiology* / Q000628:therapy; D000368:Aged; D001780:Blood Coagulation Tests; D005337:Fibrin / Q000737:chemistry; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D008297:Male; D008855:Microscopy, Electron, Scanning; D009101:Multiple Myeloma / Q000150:complications*; D010266:Paraproteins / Q000032:analysis / Q000378:metabolism; D010446:Peptide Fragments / Q000378:metabolism; D016896:Treatment Outcome
D010266:Paraproteins; D010446:Peptide Fragments; C524059:fibrinogen gamma (151-411); D005337:Fibrin; D005340:Fibrinogen