Epsilon aminocaproic acid is the treatment of choice for

• A. von Willebrand disease
• B. Hemophilia A
• C. DIC with secondary fibrinolysis
• D. Primary fibrinogenolysis

Answer: (D)

Antifibrinolytic therapy is used when clots are being broken down too quickly because of excessive plasmin activity. Epsilon-aminocaproic acid works by blocking plasminogen from binding to fibrin and by inhibiting plasmin itself. This prevents the enzymatic degradation of fibrin, helping to stabilize formed clots.

This makes it particularly useful in primary fibrinolysis, where the problem is overactive plasmin dissolving clots rather than a deficiency of coagulation factors. In that scenario, stopping the fibrinolytic activity directly addresses the bleeding tendency.

For the other conditions: von Willebrand disease is best managed with desmopressin or von Willebrand factor concentrates; Hemophilia A is treated with factor VIII replacement; and DIC with secondary fibrinolysis involves addressing the underlying coagulopathy and bleeding risk—the use of antifibrinolytics is more situational and not the standard first-line approach.