Question

64-year-old patient with a medical history of metastatic prostate cancer. The coagulation profile showed normal platelet count, PT and PTT were at borderline, levels of most clotting factors within normal ranges, slightly decrease of fibrinogen, significant increase of FDP, decreased level of plasminogen and antiplasmin.

Could these results are compatible with the diagnosis of hyperfibrinolysis? Discuss how, knowing that the relationship between cancer and fibrinlolytic activity was clearly reported?

Answer 1

It is not hyperfibrinolysis. It is fibrinolysis only.

Because

In metastatic prostate cancer fibrionolysis can occur. Fibrionolysis, is the enzymatic breakdown of fibrin into blood clots. So in fibrionolysis there is reduction of fibrin will occur.

FDP ( fibrin degradation products) is substance remain in blood , after body resolves blood clot. So in findinolysis, the FDP will high.

Plasminogen and antiplasmin are important factors in fibrionolysis. Here it us decreased.

So over all report shows patient has fibrinolysis.

In case of hyperfibrinolysis, there will be higher decrease in fibrinogen, but here only slightly increase only present.

In case of metastatic prostate cancer, primary fibrinolysis is common. The above explained diagnostic evaluations are shows how the cancer and fibrinolysis connected.