Primary Fibrinolysis (***)

Acquired coagulation disorder characterized by systemic, pathologic activation of plasmin • Causes excessive breakdown of fibrin AND fibrinogen • Leads to hypofibrinogenemia and diffuse bleeding • Occurs without prior widespread clot formation (distinguishes it from DIC) • May occur with liver disease, malignancy, obstetric complications, or rarely after surgery

Treatment: antifibrinolytics (aminocaproic acid, tranexamic acid (Txa)) ± cryoprecipitate