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A 20 year-old male with congenital afibrinogenemia was admitted to our hospital because of chronic subdural hematoma of the right temporal area. He had had several episodes of hypersensitivity reactions to fibrinogen administration, including hypotension, bronchospasm and cutaneous rash. An intradermal test for fibrinogen was positive without precipitating antifibrinogen antibodies.Because subdural hemorrhage progressed despite of cerebral decompression by medication, fresh frozen plasma was administered usng a method of rapid desensitization after pretreatment with adrenocorticosteroid, bronchodilator, antiallergic drug and H1-antihistamine, resulting in arise of a plasma fibrinogen level to 100mg/dl without occurrence of any hypersensitivity reactions. Immediately after this procedure he received surgical therapy for the hematoma. Fresh frozen plasma could be uneventfully administered without pretreatment or rapid desensitization to maintain a plasma fibrinogen level more than 50mg/dl during 2 weeks after the operation. He is in good condition 9 months after this episode.

nihon yuketsu gakkai zasshi/nippon yuketsu gakkai zasshi

A congenital afibrinogenemic patient with severe hypersensitivity to fibrinogen administration successfully treated for subdural hematoma after fresh frozen plasma infusions and anti-allergic therapies.