title: A case of acquired dysfibrinogenemia in multiple myeloma treated with therapeutic plasma exchange.
abstract: A 70 year old Caucasian woman with IgG lamda multiple myeloma presented with uncontrollable bleeding from a bone marrow biopsy site which started days after the procedure. The patient was hyperviscous, and coagulation tests showed elevated activated partial thromboplastin time (aPTT) which was not corrected with a mixing study, elevated thrombin time and reptilase time, and possible inhibitors to Factors VIII and IX. Therapeutic plasma exchange was performed using plasma with corrections of plasma viscosity (1.6 to 1.1 centipoise) and aPTT (50 to 42.1s) observed. The bleeding was controlled, and purified IgG demonstrated dysfibrinogenemic effects of the patient's paraprotein.
authors: Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States.
authors: Ginell R
authors: GR
authors: Post
authors: Lindsey
authors: L
authors: James
authors: Daisy
authors: D
authors: Alapat
authors: Virginia
authors: V
authors: Guillory
authors: Michele
authors: M
authors: Cottler-Fox
authors: Mayumi
authors: M
authors: Nakagawa
mesh_terms: D000347:Afibrinogenemia / Q000628:therapy*; D000368:Aged; D005260:Female; D006801:Humans; D009101:Multiple Myeloma / Q000097:blood* / Q000628:therapy*; D010951:Plasma Exchange / Q000379:methods*