DISSEMINATED INTRAVASCULAR COAGULATION IN ENDEMIC HEPATOSPLENIC SCHISTOSOMIASIS

Thrombin and plasmin generation were assessed in patients with endemic hepatosplenic schistomiasis (15 hepatosplenomegalic, 15 splenomegalic , 15 with advanced hepatic fibrosis and ascites and 15 hepatosplenic p atients with hematemesis). Prolongation of prothrombin time, partial t hromboplastin time and thrombin time, thrombocytopenia, hypofibrinogen emia, a decrease in antithrombin III and protein C and S levels and el evation in fibrinopeptide A, D-dimer and thrombin-antithrombin complex levels were detected in all groups, The deficit in hemostatic paramet ers was more pronounced with the advancement of the disease and was ma ximal in the hematemesis group. Our data demonstrate an increase in bo th thrombin and plasmin generation and indicate that low grade dissemi nated intravascular coagulation may occur in association with endemic Egyptian hepatosplenic schistosomiasis even in the steady state withou t overt bleeding.