Fibrinogen Levels

Fibrinogen is factor I of the blood clotting system. It belongs to the acute phase proteins and is synthesized in the liver. In the context of blood coagulation, fibrinogen is the substrate of plasmatic coagulation. Initially, the cleavage of fibrinopeptides A and B results in the conversion of fibrinogen to fibrin. Subsequent cross-linking results in a fibrin clot, which, together with other processes, eventually leads to occlusion of the blood vessel.As an acute-phase protein, it rises to high concentrations in inflammatory reactions with a delay of 24-48 hr.Several studies have demonstrated that elevated fibrinogen is also an independent risk factor for atherosclerosis (arteriosclerosis, hardening of the arteries). This in turn leads to a significantly increased risk of cardiovascular events such as myocardial infarction (heart attack) or apoplexy (stroke).

The procedure

Material needed

  • Citrate blood (fill citrate monovette correctly).

Preparation of the patient

  • Not known

Disruptive factors

  • None known

Normal values

Adult 1.8 to 3.5 g/l (5.4-10.5 µmol/l)

Indications

  • Clarification of hemorrhagic diathesis (pathologically increased bleeding tendency) (fibrinogen deficiency?).
  • Clarification of a thrombophilic diathesis (pathological tendency to form blood clots/thromboses)(dysfibrinogenemia?)
  • V.a. consumption coagulopathy or in the presence of consumption coagulopathy (coagulation disorder caused by activation of blood clotting in the vessels).
  • Hyperfibrinolysis (increased fibrinolysis/dissolution of fibrin; risk of bleeding!).
  • Follow-up of asparaginase therapy (substitution indication?).
  • Fibrinolytic therapy with streptokinase, urokinase.

Interpretation

Elevated levels of fibrinogen are found in the following conditions or diseases:

Increased fibrinogen formation

  • Inflammation* , tumors* . Values up to 10 g/l are measured
  • Chronic active-inflammatory processes* , e.g., rheumatoid arthritis, are associated with long-lasting hyperfibrinogenemia
  • Diabetic metabolic derailments* .
  • Compensation to protein losses, especially albumin
  • Postoperative*
  • Diabetic metabolic derailment*
  • Hereditary, this represents a risk factor for atherosclerotic-related diseases such as myocardial infarction (heart attack) or apoplexy (stroke)
  • Uremia*
  • Burns*

* Acute phase protein.

Decreased levels of fibrinogen are found in the following conditions or diseases:

Decreased fibrinogen formation.

  • Severe liver damage, e.g., in hepatitis (inflammation of the liver), cirrhosis (shrunken liver, with decreasing liver function), tuberous leaf fungus poisoning
  • Circulatory disorder of the liver
  • In the newborn normal, because lower synthesis power.
  • Asparaginase therapy
  • Severe blood loss

Increased fibrinogen consumption

  • Disseminated intravascular coagulation; disseminated intravascular coagulation (DIC syndrome, for short; consumption coagulopathy).
  • Release of coagulation activators from tumor cells during chemotherapy.
  • Hemolysis
  • Extensive burns, large hemorrhages
  • Metastatic carcinoma (cancer, with formation of daughter tumors).
  • Shock states
  • Fibrinolytic therapy

Congenital AfibrinogenemiaIn this hereditary, autosomal recessive disorder, fibrinogen is absent from the blood. The clinical symptoms are similar to those of hemophilia (bleeding disorder), that is, bleeding tendency with severely delayed to abolished blood clotting.