Abstract THE TERMS defibrination syndrome1 and consumption coagulopathy2 have been used to describe the condition manifested clinically by an abnormal bleeding tendency and involving decreased fibrinogen, platelets, factor II (prothrombin), factor V (proaccelerin), and factor VIII (antihemophilic globulin). This entity has been associated with numerous clinical conditions including sepsis,1 extensive surgery and secondary bleeding,1 hemolysis,2 abruptio placentae,3 and neoplasms.4 Review articles1,2 on the defibrination syndrome do not cite dissecting aneurysm as an associated condition. We have observed a patient with a dissecting aneurysm of the aorta who had coagulation defects suggestive of the defibrination syndrome. This report appears to be the first case study associating dissecting aneurysm with coagulation defects. Report of a Case A 51-year-old Negro woman was seen in the emergency room of the Jewish Hospital of Brooklyn on Jan 9, 1966, because of "aching" pain in the left knee. Approximately five hours prior to admission, the patient experienced References 1. Rosner, F., and Ritz, N.D.: The Defibrination Syndrome , Arch Intern Med 117:17, 1966.Crossref 2. Rodriguez-Erdmann, F.: Bleeding Due to Increased Intravascular Blood Coagulation: Hemorrhagic Syndromes Caused by Consumption of Blood Clotting Factors (Consumption-Coagulopathies) , New Eng J Med 273:1370, 1965.Crossref 3. Pritchard, J., and Wright, M.: Pathogenesis of Hypofibrinogenemia in Placental Abruption , New Eng J Med 261:218, 1959.Crossref 4. Prout, G.R., et al: Hemorrhagic Diathesis in Patients With Carcinoma of Prostate , JAMA 160:840, 1956.Crossref 5. Lee, R.I., and White, P.D.: Clinical Study of Coagulation Time of Blood , Amer J Med Sci 145:495, 1913.Crossref 6. Ivy, A.C.; Shapiro P.R.; and Melnick, P.: The Bleeding Tendency in Jaundice , Surg Gynec Obstet 60:781, 1935. 7. Brecher, G., and Cronkite, E.P.: Morphology and Enumeration of Human Blood Platelets , J Appl Physiol 3:365, 1950. 8. Biggs, R., and MacFarlane, R.G.: " One Stage Prothrombin ," in Human Blood Coagulation and Its Disorders , ed 3, Philadelphia: F. A. Davis Company, 1962, p 385. 9. Rodman, N.F.; Barrow, E.M.; and Graham, J.B.: Diagnosis and Control of the Hemophiliod States With the Partial Thromboplastin Time (PTT) Test , Amer J Clin Path 29:525, 1958. 10. Sherry, S.: Fibrinolysis and Afibrinogenemia , Anesthesiology 27:465, 1966.Crossref 11. Fowell, A.H.: Turbidimetric Method of Fibrinogen Assay , Amer J Clin Path 25:340, 1955. 12. Spittell, J.: Dissecting Aneurysm (Dissecting Hematoma of the Aorta) , Mod Conc Cardiov Dis 32:837, 1964. 13. Hirst, A.E.; Johns, V.J.; and Mime, W.S.: Dissecting Aneurysm of the Aorta: A Review of 505 Cases , Medicine 37:217, 1958.Crossref 14. Levinson, D.C.; Edmeades, D.T.; and Griffith G.C.: Dissecting Aneurysm of the Aorta: Its Clinical, Electrocardiographic, and Laboratory Features: A Report of Fifty-Eight Autopsied Cases , Circulation 1:360, 1950.Crossref 15. Baer, S., Varied Manifestations of Dissecting Aneurysm of the Aorta , JAMA 161:689, 1956.Crossref 16. Sherlock, S.: " The Haematology of Liver Disease ," in Diseases of the Liver and Biliary System , ed 3, Philadelphia: F. A. Davis Company 1963, p 69. 17. Mindrum, G., and Glueck, H.I.: Plasma Prothrombin in Liver Disease: Its Clinical and Prognostic Significance , Ann Intern Med 50:1370, 1959.Crossref 18. Rapaport, S.I., et al: Plasma Clotting Factors in Chronic Hepato Cellular Disease , New Eng J Med 263:278, 1960.Crossref 19. Deykin, D.: The Role of the Liver in Serum Induced Hypercoagulability , J Clin Invest 45:256, 1966.Crossref 20. Niewiarowski, S.; Bankowski, E.; and Rogowicka, I.: Studies on the Adsorption and Activation of the Hageman Factor (Factor XII) by Collagen and Elastin , Thromb Diath Haemorrh 14:387, 1965.
Archives of Internal Medicine – American Medical Association
Published: May 1, 1967