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The degradation products of fibrinogen and fibrin are fragments of fibrin formed as a result of the intensification of the process of fibrinolysis – the breakdown of intravascular clots. They are formed as a result of the action of plasmin on fibrin and fibrinogen. Fibrinogen testing is mainly performed in the diagnosis of DIC syndrome.
A few words about fibrinogen …
Fibrinogen is one of the blood coagulation factors, which is classified as plasma protein and is involved in the final stage of the clotting process. Its production takes place in the liver. This protein turns into fibrin (fibrin), which forms a blood clot. Fibrinogen testing is used primarily in the diagnosis and monitoring of DIC treatment, i.e. intravascular coagulation syndrome. Increased concentration of this factor is observed especially as a result of inflammation and infection. However, its low level can be observed in malnourished people.
When do we perform fibrinogen testing?
The indications for the fibrinogen determination are listed below.
1. Suspicion of intensification of coagulation and fibrinolysis processes (intravascular coagulation syndrome) – in the course of shock, sepsis, after delivery. In the diagnosis of DIC, additional tests are performed: PT, aPTT, platelet count, FDP and the number of d-dimers.
2. DIC treatment monitoring.
3. Sometimes monitoring of an advanced chronic disease, eg of the liver.
4. Severe general condition.
5. Suspicion of venous thrombosis and pulmonary embolism.
6. The occurrence of bleeding episodes of unknown origin. Especially prolonged.
7. The occurrence of symptoms in the form of: abdominal and muscle pain; nausea, vomiting; decreased urine output and bleeding gums. These are symptoms that may indicate the presence of DIC.
8. Assessment of the risk of cardiovascular diseases.
9. Diagnosis of hereditary deficiency of blood coagulation factors or their abnormal functioning.
10. Monitoring of the coagulation system in patients suffering from acquired coagulation disorders.
The course of the study of fibrinogen
Material for fibrinogen testing: serum.
Preparation for the test: it does not require special preparation.
The course of the study: one-time blood sampling from a vein in the arm (from the inside). Before collecting the material, the injection area is thoroughly cleaned with a special disinfectant.
Waiting time for the fibrinogen result: 1 Day.
Standard: less than 800 ng / ml. Please note that the reference ranges may differ depending on the laboratory in which the test was performed.
Comments: In differentiating the causes of excessive fibrinolytic activity, in addition to the concentration of fibrin / fibrinogen degradation products, D dimers, which are a specific breakdown product of cross-linked fibrin, are also determined. The increase in the concentration of FDP and D-dimers indicates secondary hyperfibrinolysis – in conditions with increased thrombosis and intensification of fibrinolysis processes. Primary hyperfibrinolysis is evidenced by an increase in the concentration of FDP, with the correct concentration of D-dimer.
Interpretation of research results
1. Low fibrinogen concentration may result from:
- malnutrition,
- liver diseases,
- an acquired or inborn problem with the production of fibrinogen,
- DIC team,
- certain cancers
- too high activity of proteolytic proteins, which are responsible for the breakdown of fibrinogen and fibrin,
- taking preparations in the form of: fibrinolytic drugs, androgens or barbiturates,
- frequent blood transfusions (stored blood loses fibrinogen over time),
- dysfibrinogenemia (gene mutations cause an abnormal protein and dysfunction of fibrinogen).
2. A high concentration of fibrinogen is a response to inflammatory reactions or tissue damage. The main reasons for the high level of fibrinogen are:
- injuries,
- stroke,
- Hodgkin’s disease (Hodgkin’s disease),
- tumors,
- infarct,
- coronary heart disease,
- smoking,
- pregnancy,
- rheumatoid arthritis,
- glomerulonephritis,
- taking estrogens, oral contraceptives,
- treatment with hormone replacement therapy.
How can fibrinogen be lowered?
High fibrinogen, which occurs in pregnant women or as a result of acute inflammation, usually returns to normal spontaneously after the factor causing it has subsided. The situation is different when the cause of high fibrinogen is rheumatoid arthritis or a chronic inflammatory process. Then there’s not much you can do. The doctor aims to reduce the triggers by quitting smoking, shedding unnecessary kilograms or increasing physical activity. Patients should also have their total cholesterol tested and take care to lower it. In addition, there is evidence of the positive effects of omega-3 and omega-6 fatty acids.