systemic fibrinolysis (fibrinolytic disorder)

Etiology

• chronic liver disease
• primary amyloidosis
• malignancy

Pathology

circulating activators of fibrinolysis

Laboratory

• in vitro clot lysis times are shorter than normal (in vitro clot lysis time is normal in DIC)
• platelet count is generally normal
• PT & aPTT may be prolonged (plasmin degrades factor V & factor VIII)
• thrombin time is prolonged (due to fibrin degradation products or hypoalbuminemia)
• see ARUP consult

Management

• antifibrinolytic agents
  • epsilon-aminocaproic acid (Amicar)
  • tranexamic acid

More general terms

• fibrinolysis