Hemorrhagic disorders of fibrinolysis: a clinical review

Journal of Thrombosis and Haemostasis : JTH
J L SaesM R Nijziel

Abstract

Hyperfibrinolytic bleeding can be caused by a deficiency of one of the inhibitors of fibrinolysis (plasminogen activator inhibitor type 1 [PAI-1] or α2-antiplasmin [α2-AP]), or an excess of one of the activators of fibrinolysis: tissue-type plasminogen activator or urokinase-type plasminogen activator. This review focuses on the clinical implications of these disorders. The bleeding phenotype of fibrinolytic disorders is characterized by delayed bleeding after trauma, surgery and dental procedures. Bleeding in areas of high fibrinolytic activity is also common, such as menorrhagia and epistaxis. Patients with α2-AP deficiency present with the most severe bleeding episodes. Recently, it was discovered that hyperfibrinolytic disorders are associated with a high rate of obstetric complications such as miscarriage and preterm birth, especially in PAI-1 deficient patients. Hyperfibrinolytic disorders are probably underdiagnosed because of lack of knowledge and lack of accurate diagnostic tests. A substantial part of the large group of patients diagnosed as 'bleeding of unknown origin' could actually have a hyperfibrinolytic disorder. In the case of a high index of suspicion (i.e. because of a positive family history, recurrent bleed...Continue Reading

References

Dec 23, 1978·Lancet·K KoieJ Takamatsu
Jul 28, 1979·Lancet·C KluftE J Brommer
May 1, 1979·The Journal of Clinical Investigation·N AokiM Kobakura
May 1, 1989·The Journal of Clinical Investigation·R R SchleefL J Levitt
Apr 1, 1985·Journal of Clinical Pathology·P Kettle, E E Mayne
Oct 1, 1984·The Journal of Clinical Investigation·P B TracyG E Rivard
Apr 4, 1981·British Medical Journal·D A TabernerP Ackrill
Dec 1, 1994·American Journal of Clinical Pathology·J E HumphriesM E Williams
Jul 15, 1998·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·K MeijerJ van der Meer
Apr 1, 1999·The New England Journal of Medicine·J S MenellK A Hajjar
Jul 20, 2001·Annals of the New York Academy of Sciences·H R Lijnen
Jul 27, 2001·British Journal of Haematology·R FavierP de Moerloose
Jan 25, 2003·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Michel M L HanssMarc Dechavanne
Mar 18, 2004·Blood·Heather McKayCatherine P M Hayward
Mar 26, 2004·Thrombosis Research·Amy A SmithMarilyn J Manco-Johnson
Jul 13, 2004·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Thomas Repine, Michael Osswald
Sep 11, 2004·Haemophilia : the Official Journal of the World Federation of Hemophilia·Y MorimotoT Kirita
Jan 15, 2005·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Zi Yan ZhangChang Geng Ruan
Jan 27, 2005·Journal of Thrombosis and Haemostasis : JTH·C P M HaywardE Jurriaans
Apr 22, 2005·British Journal of Haematology·Gabriela Cesarman-Maus, Katherine A Hajjar
Jun 9, 2005·European Journal of Pediatrics·Vanessa LargentChristiane Vermylen
Jul 20, 2005·Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Für Klinische Und Experimentelle Ophthalmologie·Claudia KuhliLars-Olof Hattenbach
Jan 18, 2006·Journal of Thrombosis and Haemostasis : JTH·A AgrenS Schulman
Feb 14, 2007·Journal of Vascular and Interventional Radiology : JVIR·Charles W BowkleySun H Ahn
Nov 2, 2007·Journal of Thrombosis and Haemostasis : JTH·D C RijkenW Nieuwenhuizen
Jan 25, 2008·Journal of Thrombosis and Thrombolysis·Maryam Yavari, Richard C Becker
Feb 16, 2008·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Maria DiamandisCatherine P M Hayward
Jul 5, 2008·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Maria DiamandisCatherine Pm Hayward

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Citations

Aug 24, 2019·British Journal of Haematology·Melek AkayLouise Bowles
Aug 31, 2019·Haemophilia : the Official Journal of the World Federation of Hemophilia·Joline L SaesWaander L van Heerde
Jul 17, 2019·Current Drug Targets·Tetsumei UranoFrancis J Castellino
Sep 24, 2020·The Journal of International Medical Research·Jianxia HuangPei He
Aug 13, 2020·JGH Open : an Open Access Journal of Gastroenterology and Hepatology·Bernd FroesslerRajvinder Singh
Oct 1, 2020·Methods and Protocols·Julie Brogaard Larsen, Anne-Mette Hvas
Oct 24, 2020·Haemophilia : the Official Journal of the World Federation of Hemophilia·Will ThomasMichael J R Desborough
Jan 5, 2021·Frontiers in Physiology·Giris JacobBenjamin Brenner
Aug 21, 2019·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Shilpa Jain, Suchitra S Acharya
Apr 21, 2021·Seminars in Thrombosis and Hemostasis·Maria J ColominaAntoni Sabate
May 8, 2021·Journal of Medical Case Reports·Bashir Abdrhman Bashir Mohammed
May 25, 2021·Research and Practice in Thrombosis and Haemostasis·Dino MehicJohanna Gebhart
Jul 3, 2021·International Journal of Molecular Sciences·Massimo FranchiniPier Mannuccio Mannucci
Aug 19, 2021·Hematology/oncology Clinics of North America·Jori E MayMing Yeong Lim
Oct 29, 2019·Journal of Medicinal Chemistry·Torsten SteinmetzerSimon J A Wiedemeyer

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