title: [Hypofibrinogenemia caused by long-term administration of hemocoagulase: three cases report and literature review].
abstract: OBJECTIVE
  A first report of 3 patients who developed hypofibrinogenemia due to long-term administration of hemocoagulase.
  
  
  METHODS
  The clinical data of three patients with hypofibrinogenemia due to long-term administration of hemocoagulase were analyzed, and the related literature was reviewed.
  
  
  RESULTS
  Case 1, a two-year old girl, had liver traumatic rupture and then treated with massive transfusion and fibrinogen infusion in addition to intravenous recombinant factor VIIa (two times) and hemocoagulase (2 U/d). The liver wound bleeding was soon stopped. However, her plasma fibrinogen level decreased to 0.12 g/L after continuous administration of hemocoagulase for 18 days. Case 2, a three-year old boy, had liver traumatic rupture and was treated with surgical repair, and then received hemocoagulase (2 U/d). On the 8th day, a large amount of blood was found to exude from abdominal cavity drainage tube and indwelling venous catheter, and his fibrinogen dropped to 0.24 g/L. Case 3 was a 45 year-old man who underwent a total mandibular resection because of malignant tumor, and he was given hemocoagulase (4 U/d). A continuous blood oozing was noted from his operation incision, and his fibrinogen level decreased to 0.25 g/L. All the three patients'plasma fibrinogen levels and coagulation tests returned to normal ranges after discontinuation of hemocoagulase administration and supplement of fibrinogen, and the bleeding stopped in cases 2 and 3.
  
  
  CONCLUSIONS
  Long-term use of hemocoagulase could induce hypofibrinogenemia and severe bleeding.
authors.affiliation: Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China.
authors.forename: Zhaoyue
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China.
authors.forename: Jianqin
authors.initials: J
authors.lastname: Li
authors.affiliation: Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China.
authors.forename: Lijuan
authors.initials: L
authors.lastname: Cao
authors.affiliation: Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China.
authors.forename: Ziqiang
authors.initials: Z
authors.lastname: Yu
authors.affiliation: Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China.
authors.forename: Xia
authors.initials: X
authors.lastname: Bai
authors.affiliation: Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China.
authors.forename: Changgeng
authors.initials: C
authors.lastname: Ruan
mesh_terms: D000347:Afibrinogenemia / Q000139:chemically induced*; D012103:Batroxobin / Q000008:administration & dosage / Q000009:adverse effects*; D001777:Blood Coagulation; D002675:Child, Preschool; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D005340:Fibrinogen; D012103:Batroxobin