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Acquired alpha 2 plasmin inhibitor deficiency with manifestation of hemarthrosis in a patient with spur cell anemia



Acquired alpha 2 plasmin inhibitor deficiency with manifestation of hemarthrosis in a patient with spur cell anemia



Kawasaki Medical Journal 10(3): 155-160



A male patient of alcoholic hepatic cirrhosis with spur cell anemia manifesting accelerated hemolysis and spontaneous hemarthrosis was presented. His plasma antihemophilic factor level was within the normal limits. He was 45 yr old, had a history of 20 yr of alcoholism and transferred to Kawasaki Medical School hospital because of progressive anemia and bleeding tendency. About 30% of the red cells of the peripheral blood smear were spur cells. The diagnosis of spur cell anemia was made on the basis of elevated free cholesterol contents and high value of free cholesterol/phospholipid (FC/PL) ratio of the red cell membrane lipid. During the course of his illness, spontaneous hemarthrosis appeared suddenly in the right knee joint, but the plasma antihemophilic factor level was normal. The level of the .alpha.2-PI [plasmin inhibitor] was as low as 0.98 mg/dl at that time. .alpha.2-PI deficiency evidently was the most important factor for causing hemarthrosis in this patient with hepatic cirrhosis.

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Accession: 004657622

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