title: [Analysis of hypofibrinogenemias found on routine coagulation screening tests and identification of heterozygous dysfibrinogenemia or fibrinogen deficiency].
abstract: We analyzed the clinical factors resulting in hypofibrinogenemia, which is defined as less than 100mg/dl of plasma fibrinogen values determined by a procedure based on the Thrombin-time method. Within a 12-month period, we assayed 5,746 patients (19,309 plasmas) and found 113 patients (1.97%) with hypofibrinogenemia. We categorized these patients as having decreased synthesis of fibrinogen (less than 3.0g/dl of albumin, 140 IU/l of Cholinesterase, and/or 50% on Hepaplastin Test), increased consumption of fibrinogen (more than 10 microg/ml of FDP D-dimer), known side effect of L-asparaginase administration, or other causes. Details are follows: 1) decreased synthesis: 26 patients, suspected of decreased synthesis (albumin: 3.1-3.4 g/dl): 4 patients, 2) increased consumption: 15 patients, suspected of increased consumption (FDP D-dimer: 5.0-9.9 g/dl): 1 case, 3) decreased synthesis combined with increased consumption: 24 patients, suspected of decreased synthesis and/or suspected of increased consumption: 14 patients, 4) side-effect of L-asparaginase administration: 24 patients, 5) heterozygous dysfibrinogenemia: 1 patient, 6) heterozygous fibrinogen deficiency: 1 patient, suspected of heterozygous fibrinogen deficiency: 1 patient, 7) unidentified: 2 patients with West syndrome treated with a combination of ACTH and valproic acid. Three patients with dysfibrinogenemia or fibrinogen deficiency showed normal or slightly prolonged PT values and normal APTT values. These data and our previous reports suggest that heterozygous patients with dysfibrinogenemia or fibrinogen deficiency do not demonstrate markedly prolonged PT and APTT values, differing from patients with afibrinogenemia.
authors.affiliation: Department of Laboratory Medicine, Shinshu University Hospital, Matsumoto.
authors.forename: Masako
authors.initials: M
authors.lastname: Hirota-Kawadobora
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Ishikawa
authors.forename: Noriko
authors.initials: N
authors.lastname: Fujihara
authors.forename: Saki
authors.initials: S
authors.lastname: Wakabayashi
authors.forename: Yuka
authors.initials: Y
authors.lastname: Kamijo
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Yamauchi
authors.forename: Fumiko
authors.initials: F
authors.lastname: Terasawa
authors.forename: Nobuo
authors.initials: N
authors.lastname: Okumura
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Katsuyama
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000009:adverse effects; D000347:Afibrinogenemia / Q000175:diagnosis* / Q000209:etiology* / Q000235:genetics; D001215:Asparaginase / Q000009:adverse effects; D005340:Fibrinogen / Q000096:biosynthesis / Q000378:metabolism; D006579:Heterozygote; D006801:Humans; D007223:Infant; D013036:Spasms, Infantile / Q000150:complications; D013918:Thrombin Time; D014635:Valproic Acid / Q000009:adverse effects
chemical_list: D014635:Valproic Acid; D005340:Fibrinogen; D000324:Adrenocorticotropic Hormone; D001215:Asparaginase