Acquired hypofibrinogenemia: current perspectives

Abstract

Acquired hypofibrinogenemia is most frequently caused by hemodilution and consumption of clotting factors. The aggressive replacement of fibrinogen has become one of the core principles of modern management of massive hemorrhage. The best method for determining the patient’s fibrinogen level remains controversial, and particularly in acquired dysfibrinogenemia, could have major therapeutic implications depending on which quantification method is chosen. This review introduces the available laboratory and point-of-care methods and discusses the relative advantages and limitations. It also discusses current strategies for the correction of hypofibrinogenemia.

Human Fibrinogen: Molecular and Genetic Aspects of Congenital Disorders

“…Fibrinogen disorders may be due to acquired or genetic causes. Liver diseases, cancer, disseminated intravascular coagulation (DIC), post-translational modifications, assay interferences are some of well-known causes of acquired fibrinogen disorders [ 13 ]. Inherited disorders of fibrinogen molecules, the topic of this review, are due to genetic alterations occurring within genes coding for the fibrinogen chains.…”

Deiminated proteins in extracellular vesicles and serum of llama (Lama glama)—Novel insights into camelid immunity

“…In camelids, fibrinogen is a biomarker for stress and infection (Greunz et al, 2018;El-Bahr and El-Deeb, 2016;El-Deeb and Buczinski, 2015). Impaired mechanism of fibrinogen formation and fibrin polymerization are implicated with various pathologies including coagulopathies and ischemic stroke (Weisel and Litvinov, 2013), while acquired fibrinogen disorders can be associated with cancer, liver disease or post-translational modifications (Besser and MacDonald, 2016). Fibrinogen is indeed a known deimination candidate and this post-translational modification contributes to its antigenicity in autoimmune diseases (Hida et al, 2004;Muller and Radic, 2015;Blachère et al, 2017).…”

L-Asparaginase Induced Hypofibrinogenemia: A Case Report

“…Congenital abnormalities include Type I afibrinogenemia which is caused by mutations in both chromosomal alleles of fibrinogen gene whereas Type II dysfibrinogenemia is basically due to mutations in one chromosomal allele of fibrinogen gene [4,5]. Acquired causes include reduced synthesis due to liver disease, increased consumption due to sepsis, cancer, and tissue plasminogen activator therapy, and hemodilution due to massive transfusions and due to autoantibody against fibrinogen in case of autoimmune diseases [6]. Many drugs are also known to cause hypofibrinogenemia including prednisolone, alteplase, tigecycline, isotretinoin therapy, autoantibodies produced due to isoniazid, and also bovine fibrin glue used in surgeries.…”