MEASURING PLASMA-FIBRINOGEN LEVELS IN PATIENTS WITH LIVER-CIRRHOSIS -THE OCCURRENCE OF PROTEOLYTIC FIBRIN(OGEN) DEGRADATION PRODUCTS AND THEIR INFLUENCE ON SEVERAL FIBRINOGEN ASSAYS
Mpm. Demaat et al., MEASURING PLASMA-FIBRINOGEN LEVELS IN PATIENTS WITH LIVER-CIRRHOSIS -THE OCCURRENCE OF PROTEOLYTIC FIBRIN(OGEN) DEGRADATION PRODUCTS AND THEIR INFLUENCE ON SEVERAL FIBRINOGEN ASSAYS, Thrombosis research, 78(4), 1995, pp. 353-362
In patients with liver cirrhosis the fibrinogen molecule is under cons
tant attack of various proteolytic enzymes, which might affect results
of the different assay systems for fibrinogen. We therefore studied t
he measurement of fibrinogen in the plasma of patients with mild, mode
rate and severe cirrhosis of the liver. Fibrinogen levels were measure
d with the Clauss method (functional fibrinogen); an enzyme immune ass
ay (EIA) for HMW+LMW fibrinogen; and an assay that measures the total
clottable fibrinogen. With all three methods we found normal or slight
ly increased fibrinogen levels in patients with mild or moderate cirrh
osis, whereas patients with severe cirrhosis had decreased levels. No
evidence was found for increased partial fibrinogen proteolysis, resul
ting in increases of LMW'-fibrinogen in cirrhotic patients. We further
observed that fibrinogen degradation products levels increased slight
ly with the severity of the disease, but were still in the normal rang
e in patients with severe cirrhosis. This indicates a very low level o
f primary fibrinolysis. Fibrin degradation products levels increased m
uch stronger, which points to intravascular coagulation. The levels of
the fibrin degradation products remained below the level where they a
re expected to influence the Clauss assay. In patients with liver cirr
hosis the measurement of plasma fibrinogen levels with the three studi
ed methods give comparable results. We suggest to apply the Clauss ass
ay in cirrhotic patients because of this and because it has a good rep
roducibility and because the test is cheap, quick and easy to perform.