Clinical significance of "circulating fibrin monomers'.

During the decade 1970-9 we investigated circulating fibrin monomers in 3293 patients. Fibrinaemia was determined by means of the ethanol gelation test (EGT). This was positive in 149 patients (4.5%) and was highly correlated with fibrogenal fibrin products. In many diseases the test was only transiently positive (1 or 2 days). However in patients with circulating fibrin monomers, demonstrable for more than 5 days (chronic fibrinaemia) malignant disease was associated in 63%. Chronic fibrinaemia occasionally preceded overt malignancy by a long period. Overall, only 10.8% of patients with malignant disease showed chronic fibrinaemia. The clinical symptoms most often associated with chronic fibrinaemia were those of venous thrombosis (42.8%) and abnormal bleeding (10.7%). Thromboembolism in the absence of malignant disease only occasionally showed short-term positive EGT and chronic fibrinaemia was never seen. Almost half (46.5%) of patients with chronic fibrinaemia had neither thromboembolic disease nor a haemorrhagic diathesis.