RICHARD B. SOLOMON, M.D.
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To the editor: The paper entitled "Defibrination in Acute Pancreatitis" (Ann Intern Med 76:73-76, 1972) requires some comment. Although the data support the presence of a fibrinolytic state (proteolysis of casein, fibrinogen degradation products, diminished plasminogen level, shortened euglobulin lysis time, prolonged thrombin time), there is no definite evidence favoring associated defibrination. Normal levels of factors V and VIII, moderate depression of factors VII and IX, and the absence of schistocytes are not characteristic of defibrination. The reduced platelet count could be explained by the preceding L-asparaginase therapy. Tests for the presence of fibrin monomer (for example, protamine sulfate), thought
SOLOMON RB. Defibrination or Primary Fibrinolysis?. Ann Intern Med. ;77:328. doi: 10.7326/0003-4819-77-2-328_1
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Published: Ann Intern Med. 1972;77(2):328.
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