Three cases of defibrination syndrome and bleeding tendency are described. In each case the aetiology was completely different but thrombocytopenia and fibrinogenopenia were present together. This combination is invariably due to diffuse intravascular clotting and it is suggested that these simple investigations should be asked for in cases of unexplained shock, acute renal failure of obscure origin, severe intravascular haemolysis, septic abortions, etc.
Heparin would appear to be of value in these cases of defibrination.
However, if there is no thrombocytopenia, defibrination may be due to excessive fibrinolysis. This should be treated with anti-fibrinolytics only when an underlying clotting defect has been excluded.
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