Rg. Cobcroft et al., FLUCTUATING SYMPTOMATIC CRYOFIBRINOGENEMIA IN A PATIENT WITH LEFT ATRIAL-MYXOMA, British Journal of Haematology, 88(1), 1994, pp. 213-214
We report a case of left atrial myxoma associated with a fluctuating l
evel of cryofibrinogen. Her initial symptoms and signs were consistent
with primary cryofibrinogenaemia, but a repeat episode occurred witho
ut the cryofibrinogen being detectable. A more typically embolic cereb
ro-vascular accident (CVA) occurred, with the subsequent discovery of
the patient's myxoma. The cryofibrinogen was again present but it disa
ppeared with resection of the myxoma. We propose that the degree of ac
tivation of the coagulation system around the myxoma fluctuated, causi
ng variable conversion of fibrinogen to fibrin, so that at times parti
ally cross-linked fibrin(ogen) resulted in cryofibrinogen, but at othe
r times frank emboIi from more complete clotting occurred.