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. 1973 Sep 1;3(5878):471–473. doi: 10.1136/bmj.3.5878.471

Fibrinogen-Fibrin Degradation Product Levels in Different Types of Intravascular Haemolysis

S D Slater, C R M Prentice, W H Bain, J D Briggs
PMCID: PMC1586580  PMID: 4726152

Abstract

To examine the possibility that intravascular haemolysis may lead to intravascular coagulation we have compared the degree of fibrin deposition, as measured by levels of serum fibrinogen-fibrin degradation products (F.D.P.), in two different types of intravascular haemolysis associated with red cell fragmentation. F.D.P. levels in 56 patients with intravascular haemolysis secondary to prosthetic heart valves were compared with those in 18 patients who had microangiopathic haemolytic anaemia (M.H.A.) associated with malignant hypertension or renal disease. F.D.P. levels were raised in almost all the patients with M.H.A., and this group had significantly higher levels than any of the valve replacement groups. In contrast, in the prosthetic valve patients F.D.P. levels were usually normal and bore no relation to the degree of haemolysis. It is suggested that in the absence of other precipitating factors intravascular haemolysis will not initiate intravascular coagulation. In M.H.A., while the intravascular haemolysis appears to be a consequence of an underlying intravascular coagulation, it is likely that persistence of the coagulation disturbance is related more to factors such as small vessel damage than to the release of any thromboplastic substances from fragmented red cells.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Akbarian M., Austen G., Yurchak P. M., Scannell J. G. Thromboembolic complications of prosthetic cardiac valves. Circulation. 1968 May;37(5):826–831. doi: 10.1161/01.cir.37.5.826. [DOI] [PubMed] [Google Scholar]
  2. Andersen M. N., Gabrieli E., Zizzi J. A. Chronic hemolysis in patients with ball-valve prostheses. J Thorac Cardiovasc Surg. 1965 Oct;50(4):501–510. [PubMed] [Google Scholar]
  3. BRAIN M. C., DACIE J. V., HOURIHANE D. O. Microangiopathic haemolytic anaemia: the possible role of vascular lesions in pathogenesis. Br J Haematol. 1962 Oct;8:358–374. doi: 10.1111/j.1365-2141.1962.tb06541.x. [DOI] [PubMed] [Google Scholar]
  4. Baker L. R., Rubenberg M. L., Dacie J. V., Brain M. C. Fibrinogen catabolism in microangiopathic haemolytic anaemia. Br J Haematol. 1968 Jun;14(6):617–625. doi: 10.1111/j.1365-2141.1968.tb00368.x. [DOI] [PubMed] [Google Scholar]
  5. Brain M. C. Hemolytic-uraemic syndrome. Lancet. 1968 Dec 28;2(7583):1394–1394. doi: 10.1016/s0140-6736(68)92700-1. [DOI] [PubMed] [Google Scholar]
  6. Briggs J. D., Prentice C. R., Hutton M. M., Kennedy A. C., McNicol G. P. Serum and urine fibrinogen-fibrin-related antigen (F.R.-antigen) levels in renal disease. Br Med J. 1972 Oct 14;4(5832):82–85. doi: 10.1136/bmj.4.5832.82. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Bull B. S., Rubenberg M. L., Dacie J. V., Brain M. C. Microangiopathic haemolytic anaemia: mechanisms of red-cell fragmentation: in vitro studies. Br J Haematol. 1968 Jun;14(6):643–652. doi: 10.1111/j.1365-2141.1968.tb00370.x. [DOI] [PubMed] [Google Scholar]
  8. Charm S. E., Wong B. L. Shear degradation of fibrinogen in the circulation. Science. 1970 Oct 23;170(3956):466–468. doi: 10.1126/science.170.3956.466. [DOI] [PubMed] [Google Scholar]
  9. GAARDER A., JONSEN J., LALAND S., HELLEM A., OWREN P. A. Adenosine diphosphate in red cells as a factor in the adhesiveness of human blood platelets. Nature. 1961 Nov 11;192:531–532. doi: 10.1038/192531a0. [DOI] [PubMed] [Google Scholar]
  10. Harker L. A., Slichter S. J. Studies of platelet and fibrinogen kinetics in patients with prosthetic heart valves. N Engl J Med. 1970 Dec 10;283(24):1302–1305. doi: 10.1056/NEJM197012102832402. [DOI] [PubMed] [Google Scholar]
  11. Lewis R. A. Sickle-cell anaemia in G.-6-P.D. deficiency. Lancet. 1967 Apr 15;1(7494):852–853. doi: 10.1016/s0140-6736(67)92827-9. [DOI] [PubMed] [Google Scholar]
  12. Linton A. L., Gavras H., Gleadle R. I., Hutchison H. E., Lawson D. H., Lever A. F., Macadam R. F., McNicol G. P., Robertson J. I. Microangiopathic haemolytic anaemia and the pathogenesis of malignant hypertension. Lancet. 1969 Jun 28;1(7609):1277–1282. doi: 10.1016/s0140-6736(69)92221-1. [DOI] [PubMed] [Google Scholar]
  13. Marsh G. W., Lewis S. M. Cardiac haemolytic anaemia. Semin Hematol. 1969 Apr;6(2):133–149. [PubMed] [Google Scholar]
  14. Merskey C., Johnson A. J., Kleiner G. J., Wohl H. The defibrination syndrome: clinical features and laboratory diagnosis. Br J Haematol. 1967 Jul;13(4):528–549. doi: 10.1111/j.1365-2141.1967.tb00762.x. [DOI] [PubMed] [Google Scholar]
  15. Merskey C., Kleiner G. J., Johnson A. J. Quantitative estimation of split products of fibrinogen in human serum, relation to diagnosis and treatment. Blood. 1966 Jul;28(1):1–18. [PubMed] [Google Scholar]
  16. Mustard J. F., Packham M. A. Factors influencing platelet function: adhesion, release, and aggregation. Pharmacol Rev. 1970 Jun;22(2):97–187. [PubMed] [Google Scholar]
  17. Pederson H. J., Tebo T. H., Johnson S. A. Evidence of hemolysis in the initiation of hemostasis. Am J Clin Pathol. 1967 Jul;48(1):62–68. doi: 10.1093/ajcp/48.1.62. [DOI] [PubMed] [Google Scholar]
  18. Pitney W. R. Disseminated intravascular coagulation. Semin Hematol. 1971 Jan;8(1):65–83. [PubMed] [Google Scholar]
  19. QUICK A. J., GEORGATSOS J. G., HUSSEY C. V. The clotting activity of human erythrocytes: theoretical and clinical implications. Am J Med Sci. 1954 Aug;228(2):207–213. doi: 10.1097/00000441-195408000-00009. [DOI] [PubMed] [Google Scholar]
  20. Rubenberg M. L., Regoeczi E., Bull B. S., Dacie J. V., Brain M. C. Microangiopathic haemolytic anaemia: the experimental production of haemolysis and red-cell fragmentation by defibrination in vivo. Br J Haematol. 1968 Jun;14(6):627–642. doi: 10.1111/j.1365-2141.1968.tb00369.x. [DOI] [PubMed] [Google Scholar]
  21. Slater S. D., Fell G. S. Intravascular haemolysis and urinary iron losses after replacement of heart valves by a prosthesis. Clin Sci. 1972 May;42(5):545–553. doi: 10.1042/cs0420545. [DOI] [PubMed] [Google Scholar]
  22. Tessier Y., Littleton P., Collet H., Marshall J., McDonald L. Plasma-fibrinogen after replacement of heart valves by grafts and prostheses. Lancet. 1971 Jan 2;1(7688):17–18. doi: 10.1016/s0140-6736(71)80007-7. [DOI] [PubMed] [Google Scholar]
  23. VERSTRAETE M., VERMYLEN C., VERMYLEN J., VANDENBROUCKE J. EXCESSIVE CONSUMPTION OF BLOOD COAGULATION COMPONENTS AS CAUSE OF HEMORRHAGIC DIATHESIS. Am J Med. 1965 Jun;38:899–908. doi: 10.1016/0002-9343(65)90009-4. [DOI] [PubMed] [Google Scholar]

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