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Fibrinogen (Factor I)


Definition


  • Fibrinogen is a glycoprotein synthesized in the liver. It is modified by thrombin to become fibrin, a visible clot. It is also an acute-phase reactant.
  • Normal range: 150 " “400 mg/dL (most abundant circulating clotting factor).

Use


  • This test detects decreased or abnormal fibrinogen.
  • It may be used to determine the severity and evolution of DIC by performing serial determinations.
  • Because of the initial elevation of fibrinogen, its determination is not useful in the diagnosis of DIC.

Interpretation


  • Severe fibrinogen deficiency may prolong PT, PTT, and TT.

Increased In "  


"  Increased fibrinogen thought to contribute to thrombophilia. ‚  
  • Acute inflammatory/infectious processes
  • Cancer
  • Pregnancy and use of oral contraceptives
  • Older age
  • Early DIC

Decreased In


  • Congenital afibrinogenemia or hypofibrinogenemia.
  • Dysfibrinogenemia (congenital or acquired).
  • DIC and pathologic fibrinolysis. Fibrinogen is consumed after initial elevation as an acute-phase reactant.
  • Very advanced liver disease.

Limitations


Preanalytic


  • Clotted specimens or those obtained with the wrong anticoagulant
  • Inappropriately filled test tubes
  • Inappropriately stored blood
  • Hyperlipidemic, icteric, or hemolyzed blood
  • Hct >55%
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