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Causes of increased and decreased fibrinogen
Last reviewed: 06.07.2025
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An increase in fibrinogen concentration or a decrease in it is noted in the following conditions and diseases.
- Hypercoagulation at various stages of thrombosis, myocardial infarction, as well as in the last months of pregnancy, after childbirth, after surgery.
- Inflammatory processes, in particular pneumonia. In this regard, determination of plasma fibrinogen concentration is used in parallel with determination of ESR to monitor the course of the inflammatory process.
- Neoplastic processes, especially lung cancer.
- Mild forms of hepatitis (fibrinogen concentration may be elevated). Severe liver damage (acute hepatitis, cirrhosis) is accompanied by a decrease in fibrinogen concentration.
- Primary fibrinolysis (fibrinogen concentration is reduced).
- DIC syndrome, in which changes in fibrinogen concentration depend on the form and stage of the process. In cases of chronic DIC syndrome, as well as in stage I of acute DIC syndrome, fibrinogen concentration is increased. Later, a decrease in fibrinogen concentration occurs, which indicates the transition of the process to the next (II and III) stages and is explained by its increased consumption. In stage II of DIC syndrome, fibrinogen concentration decreases to 0.9-1.1 g / l, and in stage III it becomes less than 0.5 g / l, or it is not determined at all. When evaluating the results of studies, it is necessary to take into account not only the absolute, but also the relative decrease in fibrinogen concentration compared to the initial, elevated values. A pronounced progressive decrease in fibrinogen concentration in stages II-III of acute DIC syndrome is regarded as an unfavorable sign, while an improvement in the condition is accompanied by an increase.
Hypo(a)fibrinogenemia
A rare hereditary coagulopathy with an autosomal recessive type of inheritance, characterized by low levels of fibrinogen in the blood.
The clinical picture of hypo(a)fibrinogenemia is dominated by severe bleeding associated with trauma (cord cutting, cephalohematoma, etc.).
The diagnosis of hypo(a)fibrinogenemia is based on a significant increase in blood clotting time with normal bleeding time. The number of platelets and PT are within normal limits, but the values of APTT, TT and autocoagulation test are increased. The fibrinogen content is sharply reduced (in afibrinogenemia - its complete absence).
Dysfibrinogenemia
Hereditary dysfibrinogenemia is a rare pathology, it is more often encountered in prematurity of newborns, often profound. The fibrinogen level is within the normal range, but functionally fibrinogen is defective. Severe bleeding associated with injuries is observed - bleeding from the umbilical cord stump, cephalohematoma, etc. Fibrinogen anomaly is detected by electrophoretic examination.
[ Treatment of hypo(a)fibrinogenemia and dysfibrinogenemia
For the treatment of hypo(a)fibrinogenemia and dysfibrinogenemia, replacement therapy is carried out: antihemophilic plasma at 10-20 ml/kg of body weight intravenously by drip or concentrated fibrinogen (100 mg/kg intravenously by drip), or a preparation of blood coagulation factor VIII (Cryoprecipitate) containing fibrinogen (1 dose - 300 mg of fibrinogen; 100 mg/kg intravenously by drip).