Reactions 1444 - 23 Mar 2013

SAlteplase

Hypofibrinogenaemia in elderly patients: 2 casereports

Two elderly patient developed severe hypofibrinoginaemiawhile receiving alteplase.

A 78-year-old woman experienced a stroke after choosing tointerrupt her usual vitamin K antagonist medication. Shereceived IV alteplase 0.8 mg/kg for 90 minutes, 3 hours afterstroke onset. She experienced intraventricular bleeding and acontra-lateral parietal haematoma on day 1. On day 6 afterthrombolysis, her vitamin K antagonists were restarted.Testing before and after thrombolysis showed a profounddecrease in fibrinogen levels at 2 hours followingthrombolysis; levels returned to normal by day 2.

A 71-year-old man received IV alteplase [dosage not stated]3 hours after stroke onset. His fibrinogen level had decreasedby 82%, 2 hours after thrombolysis. His fibrinogen levelreturned to normal within 6 weeks.

Author comment: "The increased sensitivity of fibrinogento alteplase can indicate excessive plasminogen activation orplasmin action or fibrinogen sensitivity to plasmin."Matrat A, et al. Characterization of a severe hypofibrinogenemia induced byalteplase in two patients thrombolysed for stroke. Thrombosis Research 131:e45-e48, No. 1, Jan 2013. Available from: URL: http://dx.doi.org/10.1016/j.thromres.2012.11.009 - France 803084634

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Reactions 23 Mar 2013 No. 14440114-9954/10/1444-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved