Fibrinolysis in Cholestatic Jaundice

The fibrinolytic system was studied in primary biliary cirrhosis (16 patients) and large bile duct obstruction (10 patients, nine of whom had carcinoma). Plasma fibrinolysis (plasminogen activator activity) was decreased and fibrinogen increased in both groups of patients, particularly in those with...

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Bibliographic Details
Published in:BMJ 1973-03, Vol.1 (5854), p.640-642
Main Authors: Jedrychowski, A., Hillenbrand, P., Ajdukiewicz, A. B., Parbhoo, S. P., Sherlock, Sheila
Format: Article
Language:English
Subjects:
Adult
Aged
Antifibrinolytic Agents
Antifibrinolytics
Bile Duct Neoplasms - blood
Bile Duct Neoplasms - surgery
Biliary liver cirrhosis
Cholestasis
Cholestasis - blood
Cholestasis - metabolism
Common Bile Duct
Female
Fibrin - analysis
Fibrinogen - analysis
Fibrinolysin - antagonists & inhibitors
Fibrinolysis
Fibrinolytics
Humans
Jaundice
Lipid Metabolism
Liver Cirrhosis, Biliary - blood
Liver Function Tests
Male
Middle Aged
Palliative Care
Pancreatic Neoplasms - blood
Pancreatic Neoplasms - surgery
Papers and Originals
Plasminogen - blood
Plasminogen activators
Postoperative Complications
Serum globulins
Thrombophlebitis - etiology
Thrombosis
Triglycerides - blood
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Summary:The fibrinolytic system was studied in primary biliary cirrhosis (16 patients) and large bile duct obstruction (10 patients, nine of whom had carcinoma). Plasma fibrinolysis (plasminogen activator activity) was decreased and fibrinogen increased in both groups of patients, particularly in those with large duct obstruction. These changes were related to the degree of cholestasis. Plasminogen activator activity was inversely related to serum triglyceride levels in patients with primary biliary cirrhosis. Urokinase inhibitors were decreased in both groups and antiplasmins increased in patients with large duct obstruction; fibrin/fibrinogen degradation products were normal in primary biliary cirrhosis and moderately increased in large duct obstruction. None of these fibrinolytic indices was related to the degree of cholestasis. Fibrinolytic activity and fibrinogen returned almost to normal levels after palliative surgery in the three patients with large duct obstruction who were studied. The decreased plasma fibrinolysis and increased fibrinogen may be due to altered lipid metabolism in cholestatic jaundice. In patients undergoing surgery for large duct obstruction there may be an increased risk of thrombosis.
ISSN:0007-1447
0959-8138
1468-5833
DOI:10.1136/bmj.1.5854.640