Summary
The clinical value of the ethanol gelation test (EGT) in diagnosing diffuse intravascular
coagulation (DIC) has been questioned because of the occasional finding of a negative
test, while other laboratory data pointed to DIC. Therefore, the behaviour of the
EGT during thrombin infusions in rabbits was studied, with special reference to the
fibrinogen level and activation of fibrinolysis. Fibrinolytic activity was inhibited
or induced by synchronous infusion of epsilon-aminocaproic acid or plasmin respectively.
The results obtained show that apart from severe depletion of fibrinogen strong activation
of fibrinolysis can cause a negative EGT during thrombin infusions in rabbits. This
phenomenon could not be ascribed to high levels of fibrin degradation products (fdp);
it might be due to plasmin digestion of fibrin monomers. In vitro studies with human
plasma confirmed that the EGT becomes negative at a fibrinogen level of less than
20 mg per 100 ml or by plasmin activity in the presence of a normal fibrinogen level.
Whereas a positive EGT is highly specific for DIC, these studies show that a negative
EGT does not exclude the presence of DIC.
