Patient was a twenty-six year-old crippled (poliomyelitis victim) single female who
was originally admitted with chief complaints of cough, fever, chest pain and localized
subcutaneous indurations involving both leg which began about two weeks prior to
admission. Few days later, patient developed hemoptysis and maculopapular rashes
involving abdominal wall.
On admission, paitient's body emprature was 38.5℃, pulse-95/min. and blood pressure
was 110/60㎜Hg. Auscultatory examination of the lungs revealed few fine moist rales in
both lower lung field and breath sound was diminished with dullness in the right base,
Otherwise no specific finding was noted. Routine laboratory tests showed RBC·
2,980,000/mm3, hemoglobin 9.0 gm/dl., WBC4,950 with normal differential
count, and ESR 61 ㎜/lhr. (uncorrected). Urine showed protein (+) only and CCF was
(+)/24 hr. Chest X-ray revealed right pleural effusion and pulmonary infection in both
lung base.
Following admission, every injection site was noted to cause ecchymoses thereby
necessitating de-tailed studies on hemostatic function, as shown in Table 2, Fig. 1. 2. 5
and 6. Plasma fibrinogen, prothrombin time and factor V were noted to be markedly
decreased on several determinations, together with positive whole blond clot Iysis.
Patient was treated with antibiotics, corticosteroid and upsilon. On tenth hospital day,
Patient suddenly developed hematemesis and melons. Subsequent course was unable to
be followed as the patient was taken home by her family against doctor's advice.
Togehter with this case report, pertinent literatures on fibrinolysis were reviewed.
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