Dysfibrinogenemia and Hypercoagulability in Patients with Membranous Glomerulopathy

C. S. Winter, R. D. Wagoner, E. J. W. Bowie, C. A. Owen
1979 VIIth International Congress on Thrombosis and Haemostasis   unpublished
Renal vein thrombosis (RVT) is a common complication in patients with nephrotic syndrome and membranous glomerulopathy (MGN). We demonstrated it angiographically in 12 of 24 consecutive patients. Thorough hemostatic surveys were done on 14, 6 with RVT. In 11 patients, 5 with RVT, platelet counts were significantly above normal, 402,000 to 700,000/mm3 blood. In all but 4 cases, plasma fibrinogen was at least twice normal (mean 588 mg/dl). Factor VIII: C levels ranged from 152 to 337 U/dl (mean
more » ... to 337 U/dl (mean 236). Antithrombin III was depressed in only one patient, lie did not have RVT. While prothrombin times, partial thromboplastin times, and activated partial thromboplastin times were normal in all patients (except when anticoagulants were being given), the thrombin time was significantly prolonged in 12 of the 14 patients (6 with RVT). In these 12 the Reptilase times were also long. The prolonged thrombin times cannot be attributed to inhibition by fibrinolytic degradation products since the FDP were elevated in only 5 cases (2 with RVT). It seems that an abnormality of the fibrinogen molecule (prolonged thrombin and Reptilase times) and "hypercoagulability" characterize the nephrotic syndrome associated with membranous glomerulopathy and possibly other renal lesions. We could not, however, distinguish between patients with and without renal vein thrombosis.
doi:10.1055/s-0039-1684425 fatcat:yzv632ukjrf7natzhhb6nv5icu