Prothrombin complex concentrates (PCC) are known to carry a risk of thromboembolism.
We have chosen to reassess the problem of detecting in vivo signs of activation of the clotting mechanism by assaying fibrinopeptide A (FpA)
after PCC administration in hemophilic patients during bleeding episodes. FpA was
significantly increased above baseline levels 15 to 60 min after the infusion of 19
doses of 5 different types of commercial PCC in 14 hemophilia B patients treated for
bleeding episodes or dental extractions. A more marked increase followed 16 infusions
of the activated PCC FEIBA and Auto IX in 4 hemophilia A patients with F. VIII inhibitors.
There was no significant FpA change after F. VIII concentrates administred to a control
group of 7 patients with hemophilia A. These findings suggest that circulation of
thrombin occurs frequently after PCC administration, even though clinical manifestations
of thromboembolism appear to be relatively rare.
Key words
Prothrombin complex concentrates - Hemophilia - Thrombogenicity - Fibrinopeptide A
