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Fibrin monomer complexes (SFMC) after substitution of antithrombin III (AT III) in consumption coagulopathy
G Töpfer1, W Ehrhardt, G Dornheim
1District Hospital of Görlitz, GDR.
Insights
Antithrombin III (AT III) donation effectively treated consumption coagulopathy in 33 patients. Monitoring AT III and soluble fibrin monomer complexes (SFMC) aids in detecting disseminated intravascular coagulation (DIC).
Area of Science:
- Hematology
- Coagulation Science
Background:
- Consumption coagulopathy, including disseminated intravascular coagulation (DIC), presents complex challenges in patient management.
- Substitution therapy is a critical aspect of treating severe coagulation disorders.
Observation:
- This study investigated the effects of Antithrombin III (AT III) substitution therapy in 33 patients with consumption coagulopathy.
- Key coagulation and fibrinolytic variables were monitored before and after treatment.
Findings:
- Successful AT III donation led to the disappearance of soluble fibrin monomer complexes (SFMC) within 0.5-12 hours.
- Decreased AT III levels correlated with a positive SFMC test, indicating recurrent DIC.
- D-dimer proved a sensitive indicator for DIC during hyperfibrinolysis.
- Fibronectin and SFMC levels showed an inverse relationship.
Implications:
- Monitoring both AT III and SFMC is recommended for early detection of DIC.
- D-dimer analysis is valuable for identifying DIC, especially in hyperfibrinolytic states.
- Understanding the interplay between fibronectin and SFMC can refine diagnostic approaches for coagulation disorders.
Abstract:
The report refers to substitution therapy of 33 patients who suffered consumption coagulopathy. Various blood coagulation and fibrinolytic variables were measured. After successful AT III donation to patients suffering DIC, soluble fibrin monomer complexes (SFMC) disappeared within 0.5-12 hours. If AT III decreases SFMC proves positive again. In addition to analysis of AT III we recommend to analyse SFMC to detect thrombin induced consumption reaction (DIC). Furthermore we found the fibrin split product D-dimer was a particularly sensitive indicator of DIC in case of hyperfibrinolysis (D-dimer was analysed in six patients). The reactions of fibronectin and SFMC proved inversely proportional.