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Abnormal fibrin polymerization in liver disease.

G Green, J M Thomson, I W Dymock

British Journal of Haematology

|November 1, 1976

Summary

Abnormal fibrinogen polymerization is common in severe liver disease, particularly cirrhosis. This fibrinogen defect, linked to poor prognosis in bleeding varices, often resolves with clinical improvement.

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Area of Science:

Hepatology
Hematology
Biochemistry

Background:

Acquired abnormal fibrinogen in liver disease is rarely reported.
The frequency and clinical significance of abnormal fibrinogen in liver disease remain unclear.

Purpose of the Study:

To determine the frequency and clinical significance of abnormal fibrin polymerization in patients with various hepatic disorders.
To investigate the association between abnormal fibrinogen and disease severity, prognosis, and clinical outcomes.

Main Methods:

Screened 121 consecutive patients with hepatic disorders for abnormal fibrin polymerization using a colorimetric Reptilase method.
Analyzed the incidence of abnormal fibrin polymerization in different liver disease subtypes, including cirrhosis, acute liver failure, chronic active liver disease, and liver tumors.

Main Results:

Abnormal fibrin polymerization was detected in 50% of cirrhosis patients, especially in decompensated alcoholic cirrhosis.
The abnormality was present in all acute liver failure cases and 7/15 chronic active liver disease patients.
Abnormal fibrin polymerization was associated with poor prognosis in bleeding esophageal varices and often resolved with clinical improvement.

Conclusions:

Abnormal fibrin polymerization is frequent in liver disease, indicating severe hepatocellular dysfunction.
Evidence suggests a primary fibrinogen abnormality causing impaired fibrin monomer polymerization in liver disease.
This finding highlights a potential diagnostic and prognostic marker in liver disease management.

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