Plasminogen Deficiency

Differential Diagnosis

Pathologically, ligneous pseudomembranes grossly appear similar to amyloid, however the congo red stain is negative and the lesions are rich in fibrin.1

Interestingly, there is a published report of a case of ligneous conjunctivitis caused by use of the fibrinolytic inhibitor tranexamic acid.31 This young woman was treated with tranexamic acid for menorrhagia; after several months of therapy, she developed conjuctival and gingival lesions. The lesions resolved with discontinuation of antifibrinoltyioc therapy. With reintroduction of tranexamic acid, the lesions recurred, documenting a causal relationship between the medication and lesions. Levels of plasminogen were not evaluated as this report was published prior to the recognition that plasminogen deficiency was the cause of ligneous conjunctivitis.