FLUCTUATING SYMPTOMATIC CRYOFIBRINOGENEMIA IN A PATIENT WITH LEFT ATRIAL-MYXOMA

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.