{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:05:05Z","timestamp":1756339505198,"version":"3.44.0"},"reference-count":19,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T00:00:00Z","timestamp":1695686400000},"content-version":"unspecified","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,9,5]]},"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:p>We report a case where tranexamic acid, which is an antifibrinolytic agent, was used to effectively treat bleeding tendency in a patient with immunoglobulin light chain (AL) amyloidosis. A male patient in his 80s without a history of bleeding disorders was admitted to our hospital for the examination of bleeding tendency and was diagnosed with a bleeding disorder due to AL amyloidosis. Blood tests revealed elevated plasmin-\u03b12-plasmin inhibitor complex levels, suggesting fibrinolytic activation. Managing the bleeding was difficult; however, we suspected fibrinolytic activation associated with AL amyloidosis and initiated treatment with oral tranexamic acid, which markedly improved the bleeding disorder and abnormalities of the fibrinolytic system. Therefore, in cases of bleeding due to fibrinolytic activation of AL amyloidosis, tranexamic acid administration can be an effective treatment.<\/jats:p>","DOI":"10.1136\/bcr-2022-254483","type":"journal-article","created":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T13:06:03Z","timestamp":1695733563000},"page":"e254483","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical effects of tranexamic acid on bleeding tendency due to fibrinolytic activation of AL amyloidosis"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6183-5672","authenticated-orcid":false,"given":"Gaku","family":"Matsumoto","sequence":"first","affiliation":[{"name":"Department of General Internal Medicine, National Hospital Organisation Nagasaki Medical Center, Omura, Nagasaki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5778-4833","authenticated-orcid":false,"given":"Hideki","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, National Hospital Organisation Nagasaki Medical Center, Omura, Nagasaki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahiro","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, National Hospital Organisation Nagasaki Medical Center, Omura, Nagasaki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chika","family":"Sakaki","sequence":"additional","affiliation":[{"name":"Department of Hematology, National Hospital Organisation Nagasaki Medical Center, Omura, Nagasaki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,9,26]]},"reference":[{"key":"2025082708143598000_16.9.e254483.1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2000.02183.x"},{"key":"2025082708143598000_16.9.e254483.2","doi-asserted-by":"crossref","first-page":"403","DOI":"10.2169\/internalmedicine.53.0898","article-title":"Clinical manifestations at diagnosis in Japanese patients with systemic AL amyloidosis: a retrospective study of 202 cases with a special attention to uncommon symptoms","volume":"53","author":"Matsuda","year":"2014","journal-title":"Intern Med"},{"key":"2025082708143598000_16.9.e254483.3","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1002\/ajh.21603","article-title":"Systemic AL amyloidosis with acquired factor X deficiency: a study of perioperative bleeding risk and treatment outcomes in 60 patients","volume":"85","author":"Thompson","year":"2010","journal-title":"Am J Hematol"},{"key":"2025082708143598000_16.9.e254483.4","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2006.03.036"},{"key":"2025082708143598000_16.9.e254483.5","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V97.6.1885"},{"key":"2025082708143598000_16.9.e254483.6","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1038\/s41572-018-0034-3","article-title":"Systemic immunoglobulin light chain amyloidosis","volume":"4","author":"Merlini","year":"2018","journal-title":"Nat Rev Dis Primers"},{"key":"2025082708143598000_16.9.e254483.7","doi-asserted-by":"crossref","DOI":"10.1097\/HS9.0000000000000454","article-title":"Systemic AL amyloidosis: current approaches to diagnosis and management","volume":"4","author":"Fotiou","year":"2020","journal-title":"Hemasphere"},{"key":"2025082708143598000_16.9.e254483.8","unstructured":"Kumar SK , Callander NS , Adekola K , et al . NCCN clinical practice guidelines in oncology: systemic light chain amyloidosis version 1; 2021."},{"key":"2025082708143598000_16.9.e254483.9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/13506129.2021.2002841","article-title":"Guidelines for high dose chemotherapy and stem cell transplantation for systemic AL amyloidosis: EHA-ISA working group guidelines","volume":"29","author":"Sanchorawala","year":"2022","journal-title":"Amyloid"},{"key":"2025082708143598000_16.9.e254483.10","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.5493"},{"key":"2025082708143598000_16.9.e254483.11","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13155"},{"key":"2025082708143598000_16.9.e254483.12","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1007\/s12185-019-02811-x","article-title":"Coagulation and fibrinolytic features in AL amyloidosis with abnormal bleeding and usefulness of tranexamic acid","volume":"111","author":"Arahata","year":"2020","journal-title":"Int J Hematol"},{"key":"2025082708143598000_16.9.e254483.13","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1080\/13506120902879269","article-title":"Excessive Fibrinolysis in AL-amyloidosis is induced by Urokinae-type plasminogen activator from bone marrow plasma cells","volume":"16","author":"Uchiba","year":"2009","journal-title":"Amyloid"},{"key":"2025082708143598000_16.9.e254483.14","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198104023041407"},{"key":"2025082708143598000_16.9.e254483.15","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.274.13.8500"},{"key":"2025082708143598000_16.9.e254483.16","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1016\/j.bbapap.2013.02.007","article-title":"Proteolytic modulation of factor Xa-antithrombin complex enhances fibrinolysis in plasma","volume":"1834","author":"Talbot","year":"2013","journal-title":"Biochim Biophys Acta"},{"key":"2025082708143598000_16.9.e254483.17","doi-asserted-by":"crossref","first-page":"e81","DOI":"10.1016\/j.clml.2013.08.007","article-title":"Fatal bleeding due to acquired factor IX and X deficiency: a rare complication of primary amyloidosis; case report and review of the literature","volume":"14","author":"Ericson","year":"2014","journal-title":"Clin Lymphoma Myeloma Leuk"},{"key":"2025082708143598000_16.9.e254483.18","unstructured":"Chauncey JM , Wieters JS . Tranexamic Acid. Treasure Island, FL: StatPearls Publishing, 2022."},{"key":"2025082708143598000_16.9.e254483.19","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1056\/NEJM196905152802011","article-title":"Epsilon aminocaproic acid--a dangerous weapon","volume":"280","author":"Ratnoff","year":"1969","journal-title":"N Engl J Med"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-254483","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:14:44Z","timestamp":1756307684000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-254483"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9]]},"references-count":19,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,9,26]]},"published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1136\/bcr-2022-254483"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-254483","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2023,9]]}}}