Plasma Antithrombin III and Plasminogen Levels in Chronic Plasmapheresis

Abstract

To the Editor: The effects of intensive plasma exchange on blood coagulation include thrombocytopenia, a decreased fibrinogen level, and elevations in prothrombin time, partial thromboplastin time, and reptilase time.¹ In addition, reductions in antithrombin III and plasminogen levels have been observed, resulting in (at least potentially) a "hypercoagulable" state.² The effects of long-term plasmapheresis on plasma proteins have been studied, ^{3 , 4} but antithrombin III and plasminogen levels have not been reported. Because of the occurrence of a thrombotic stroke in an otherwise healthy 28-year-old man participating in a long-term plasmapheresis program, and because of the established hypercoagulable state associated with congenital . . .