Thrombotic State after a Hemorrhagic Diathesis, a Possible Complication of Therapy with Epsilon-Aminocaproic Acid

A hemorrhagic state with afibrinogenemia developed in an 81 year old man with disseminated carcinoma of the prostate. Following administration of epsilon-aminocaproic acid and hydrocortisone, widespread intravascular thromboses developed. It is postulated that epsilon-aminocaproic acid inhibited fibrinolysis and thereby helped to "unmask" a process of intravascular coagulation that had initiated the hemorrhagic diathesis. Although the evidence is less convincing, the administered hydrocortisone may also have contributed to the thrombotic disorder.