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The causes of increase and decrease in fibrinogen
Last reviewed: 23.04.2024
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An increase in the concentration of fibrinogen or its reduction is noted in the following conditions and diseases.
- Hypercoagulation at various stages of thrombosis, myocardial infarction, and also in the last months of pregnancy, after childbirth, after surgical operations.
- Inflammatory processes, in particular pneumonia. In this connection, the determination of fibrinogen concentration in plasma is used in parallel with the determination of ESR to monitor the course of the inflammatory process.
- Neoplastic processes, especially with lung cancer.
- Light forms of hepatitis (the concentration of fibrinogen can be increased). Heavy liver damage (acute hepatitis, cirrhosis) is accompanied by a decrease in the concentration of fibrinogen.
- Primary fibrinolysis (fibrinogen concentration is reduced).
- DIC-syndrome, in which changes in the concentration of fibrinogen depend on the form and stage of the process. In cases of chronic form of DIC-syndrome, as well as in the first stage of acute DIC-syndrome, the concentration of fibrinogen is increased. Later, there is a decrease in the concentration of fibrinogen, which indicates the transition of the process to the following (II and III) stages and is explained by its increased consumption. In the II stage of DVS-syndrome the concentration of fibrinogen decreases to 0.9-1.1 g / l, and in 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 the fibrinogen concentration in comparison with the initial, increased indices. The pronounced progressive decrease in the concentration of fibrinogen in the II-III stages of acute DIC syndrome is regarded as an unfavorable sign, while the improvement of the condition is accompanied by its increase.
Hypo (a) fibrinogenemia
A rare hereditary coagulopathy with an autosomal recessive type of inheritance, characterized by a low content of fibrinogen in the blood.
In the clinical picture of hypo (a) fibrinogenemia, severe bleeding associated with trauma (umbilical cord cut, cephalohematoma, etc.) predominates.
Diagnosis of hypo (a) fibrinogenemia is based on a significant increase in clotting time at normal bleeding time. The number of platelets and PV is within normal limits, but the values of APTT, TV and autocoagulation test are increased. The content of fibrinogen is sharply reduced (in the case of afibrinogenemia, its complete absence).
Dysfibrinogenemia
Hereditary disfibrinogenemii - a rare pathology, it is more often met with premature infants, often deep. The level of fibrinogen is normal, but functionally fibrinogen is inadequate. Observed associated with trauma marked bleeding - bleeding from the stump of the umbilical cord, cephalohematemata, etc. Anomaly of fibrinogen is detected by electrophoretic examination.
[Treatment of hypo (a) fibrinogenemia and dysfibrinogenemia
For the treatment of hypo (a) fibrinogenemia and dysfibrinogenemia, substitution therapy is carried out: antihemophilic plasma for 10-20 ml / kg of mass intravenously drip or concentrated fibrinogen (100 mg / kg intravenously drip), or a blood coagulation factor VIII (Cryoprecipitate) containing fibrinogen 1 dose - 300 mg fibrinogen, 100 mg / kg intravenously drip).