Coagulopathy fibrinolysis

An increased consumption of coagulation factors is found in extensive disseminated intravascular coagulopathy. Secondary hyperfibrinolysis evolves. Simultaneous activation of the coagulation cascade or fibrinolysis system leads to the consumption of coagulation factors as well as inhibitors. 

Epoetin has been abused by athletes, increasing the risk of hypertension and disseminated intravascular coagulopathy (10). In athletes epoetin causes increased blood viscosity, which will further increase during dehydration, leading to risks of myocardial infarction, cerebrovascular accident, or encephalopathy (10). Epoetin induces accelerated fibrinolysis, and so epoetin doping can be detected by analysis of fibrin degradation products in urine (10). In addition, hypochromic macrocytes are increased (10). 

Kashuk JL, et al. Primary fibrinolysis is integral in the pathogenesis of the acute coagulopathy of trauma. Ann Surg 2010 252 434-42. discussion 443. ... 

Acute promyelocytic leukemia (APL) is a specific type of acute myeloid leukemia (AML) characterized by the morphology of blast cells (M3 in the French American British classification of AML) [1, 2], the t [15, 17] translocation [3] which fuses the promyelocytic leukemia (PML) gene on chromosome 15 to the retinoic acid receptor (RARa) a gene on chromosome 17 [4, 5], and by a coagulopathy combining disseminated intravascular coagulation (DIC) and fibrinolysis [6, 7]. Until recently, intensive chemotherapy, usually combining an anthracycHne and cytosine arabinoside (AraC) was the only effective treatment of APL [8-22]. 

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