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The rate of fibrinopeptide B release modulates the rate of clot formation: a study with an acquired inhibitor to fibrinopeptide B release
Author(s) -
Nawarawong Weerasak,
Wyshock Edward,
Meloni Frank J.,
Weitz Jeffrey,
Schmaier Alvin H.
Publication year - 1991
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.1991.tb04536.x
Subject(s) - thrombin , fibrinogen , partial thromboplastin time , clotting time , thrombin time , coagulation , medicine , endocrinology , chemistry , thromboplastin , clotting factor , prothrombin time , immunology , platelet
Summary An asymptomatic 50‐year‐old male with a gamma globulin paraprotein was found to have prolonged prothrombin time, activated partial thromboplastin time, and thrombin time but a normal reptilase time. The prolonged clotting times were not the result of a factor deficiency because they were not corrected by the addition of normal plasma. Instead, this patient had an antibody that delayed thrombin‐mediated fibrinopeptide B release thereby producing an apparent dysfibrinogenaemia. His isolated IgG prolonged the thrombin clotting time of both normal plasma and fibrinogen. Precincubation of his IgG with fibrinopeptide B, but not with fibrinopeptide A or thrombin, decreased its ability to prolong the thrombin clotting time. The patient's purified IgG but not control IgG delayed thrombin‐mediated fibrinopeptide B release from fibrinogen without affecting the release of fibrinopeptide A. These studies define a novel, clinically silent dysfibrinogenaemia due to an antibody that delays thrombin‐mediated fibrinopeptide B release from fibrinogen thereby markedly prolonging the clotting times.