Summary
An abnormal fibrinogen was found in a patient associated with disabling recurrent
phlebitis and pulmonary emboli, pseudotumor cerebri, gout and endometriosis. The fibrinogen
is characterized by (1) abnormal side-to-side and end-to-end polymerization, (2) abnormal
fibrinopeptide release, (3) a delayed γ-γ dimerization of the non cross-linked fibrin,
(4) a pH optimum of 7-7.8, and (5) a deviation from normal amino acid composition
with regard to lysine, aspartic acid, glutamic acid and serine. Since no defect has
been found in any of her three children, and since the prothromin and partial thromboplastin
times vary from time to time, it is assumed that the defect is acquired. Liver disease,
usually associated with acquired abnormal fibrinogen, has been excluded as an etiological
cause since liver function tests and biopsy are completely normal.