Methods for Differential Diagnosis of Consumption Coagulopathy

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Abstract
In order to find out the sensitive tests to differentiate intravascular coagulation from intravascular proteolysis, the changes in factors of coagulation-fibrinolysis were studied on experimentally produced fibrinolysis, fibrinogenolysis and intravascular coagulation. Fibrinogen, and factors V and VIII were decreased; the prothrombin time, thrombin time and partial thromboplastin time were prolonged in both intravascular proteolysis and coagulation. The reliable factors to be tested for the differentiation were the prothrombin determined by the two stage method or by employing prothromb in- free plasma, plasminogen, platelets and the split products derived from either fibrinogen or fibrin. Namely, the platelets and prothrombin were decreased in intravascular coagulation, whereas these factors were normal in proteolytic stage. Plasminogen was low in both fibrinolytic and fibrinogenolytic states, but normal in intravascular coagulation. Basing on the facts that the split products from fibrinogenolysis were heatlabile at 56°C for 15 minutes, while those from fibrinolysis were heat-stable, the differentiation between the split products from fibrinogen and fibrin was possible by measuring the thrombin clotting on a mixture of control plasma and heated or non-heated test sample, and by employing the simple radial immune diffusion technique.

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