How are fibrinogen disorders diagnosed?

Updated: Oct 06, 2020
  • Author: Irene S Pakos, DO; Chief Editor: Perumal Thiagarajan, MD  more...
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Answer

The laboratory diagnosis of dysfibrinogenemias is difficult. Fibrinogen antigen level is preserved but activity is markedly decreased. [15] . Prothrombin time (PT) appears to be more sensitive than activated partial thromboplastin time (aPTT). Thrombin time (TT) and reptilase time (RT) are typically prolonged. [16] Fibrinogen levels are usually less than 100 mg/dL in the absence of iatrogenic causes (eg, massive blood loss, antifibrinolytics agents). Screening test results (eg, PT, aPTT) may be within reference ranges or only slightly prolonged. [17] Fibrinogen levels are decreased with DIC, primary and secondary fibrinolysis, and liver disease.

Because fibrinogen is an acute-phase protein reactant, increased levels may be observed with inflammation. Pregnancy and oral contraceptive use may also increase plasma fibrinogen levels. Plasma fibrinogen levels vary between the sexes and with weight, glucose levels, triglyceride values, and low levels of high-density lipoprotein cholesterol in healthy adults. [18]

Because of all these variations, many clinicians consider measurement of fibrinogen activity by thromboelastography to be the most accurate measurement of dysfibrinogenemia or qualitative dysfunctions. [19, 20]


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