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Test ID FIBC Fibrinogen, Plasma


Specimen Required


Only orderable as part of a profile. For more information, see:

BDIAL / Bleeding Diathesis Profile, Limited

PROCT / Prolonged Clot Time Profile

THRMP / Thrombophilia Profile


Useful For

Detecting increased or decreased fibrinogen (factor 1) concentration of acquired or congenital origin

 

Monitoring severity and treatment of disseminated intravascular coagulation and fibrinolysis

Method Name

Only orderable as part of a profile. For more information, see:

BDIAL / Bleeding Diathesis Profile, Limited

PROCT / Prolonged Clot Time Profile

THRMP / Thrombophilia Profile

 

Clauss

Reporting Name

Fibrinogen, P

Specimen Type

Plasma Na Cit

Specimen Stability Information

Specimen Type Temperature Time
Plasma Na Cit Frozen 14 days

Reject Due To

Hemolysis

Mild OK; Gross reject

Lipemia

Mild OK; Gross reject

Icterus

Mild OK, Gross reject

Other

NA

Clinical Information

Fibrinogen, also known as factor 1, is a plasma protein that can be transformed by thrombin into a fibrin gel ("the clot"). Fibrinogen is synthesized in the liver and circulates in the plasma as a disulfide-bonded dimer of 3 subunit chains. The biological half-life of plasma fibrinogen is 3 to 5 days.

 

An isolated deficiency of fibrinogen may be inherited as an autosomal recessive trait (afibrinogenemia or hypofibrinogenemia) and is one of the rarest of the inherited coagulation factor deficiencies.

 

Acquired causes of decreased fibrinogen levels include acute or decompensated intravascular coagulation and fibrinolysis (disseminated intravascular coagulation), advanced liver disease, L-asparaginase therapy, and therapy with fibrinolytic agents (eg, streptokinase, urokinase, tissue plasminogen activator).

 

Fibrinogen function abnormalities, dysfibrinogenemias, may be inherited (congenital) or acquired. Patients with dysfibrinogenemia are generally asymptomatic. However, the congenital dysfibrinogenemias are more likely than the acquired to be associated with bleeding or thrombotic disorders. While the dysfibrinogenemias are generally not associated with clinically significant hemostasis problems, they characteristically produce a prolonged thrombin time clotting test. Congential dysfibrinogenemias usually are inherited as autosomal codominant traits.

 

Acquired dysfibrinogenemias mainly occur in association with liver disease (eg, chronic hepatitis, hepatoma) or renal diseases associated with elevated fibrinogen levels.

 

Fibrinogen is an acute-phase reactant, so a number of acquired conditions can result in an increase in its plasma level:

-Acute or chronic inflammatory illnesses

-Nephrotic syndrome

-Liver disease and cirrhosis

-Pregnancy or estrogen therapy

-Compensated intravascular coagulation

 

The finding of an increased level of fibrinogen in a patient with obscure symptoms suggests an organic rather than a functional condition. Chronically increased fibrinogen has been recognized as a risk factor for development of arterial and venous thromboembolism.

Reference Values

Males: 200-375 mg/dL

Females: 200-430 mg/dL

Full-term infants and premature (30-36 weeks gestation) newborn infants: fibrinogen is near adult levels (>150 mg/dl) and reaches adult levels by ≤21 days postnatal.

Interpretation

This test assesses levels of functional (clottable) fibrinogen (see Cautions).

Cautions

In patients with dysfibrinogenemias, this assay may give spuriously low results.

 

In patients with markedly elevated plasma levels of fibrin degradation products (eg, thrombolytic therapy or disseminated intravascular coagulation and fibrinolysis), clottable fibrinogen determined by this method may be lower than when measured by an end point method (eg, nephelometric) assay.

 

Patients with antibodies to bovine thrombin (which can arise in association with surgical application of topical bovine thrombin) may have spuriously decreased fibrinogen when assayed by this assay.

 

The presence of heparin above 1.0 U/mL may cause erroneously low kinetic estimates of fibrinogen, or make it impossible to measure fibrinogen by the nephelometric end point technique. In these cases, end point determinations of clottable fibrinogen by a gravimetric/spectrophotometric (biuret) technique or fibrinogen immunoassay may be helpful.

Clinical Reference

1. Dang CV, Bell WR, Shuman M: The normal and morbid biology of fibrinogen. Am J Med 1989;87:567-576

2. Bowie EJW, Owen CA Jr: Clinical and laboratory diagnosis of hemorrhagic disorders. In Disorders of Hemostasis. Edited by OD Ratnoff, CD Forbes. Philadelphia, WB Saunders Company, 1991, pp 1342-1354

3. Martinez J: Quantitative and qualitative disorders of fibrinogen. In Hematology: Basic Principles and Practice. Edited by R Hoffman, EJ Benz Jr. SH Shattil, et al. New York, Churchill Livingstone, 1991, pp 1342-1354

4. Mackie IJ, Kitchen S, Machin SJ, Lowe GD: Hemostasis and Thrombosis Task Force of the British committee for standards in haematology. Guidelines for fibrinogen assays. Br H Haemotol 2003;121:396-304

Day(s) and Time(s) Performed

Monday through Friday

Analytic Time

1 day

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

85384

LOINC Code Information

Test ID Test Order Name Order LOINC Value
FIBC Fibrinogen, P 3255-7

 

Result ID Test Result Name Result LOINC Value
FIBC Fibrinogen, P 3255-7

NY State Approved

Yes