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[Fibrin monomer assay]
H Kobayashi1, M Matsuo, K Ikeguchi
1Central Laboratory, Hyogo prefectural Awaji Hospital, Sumoto.
Abstract:
Quantitative assay for fibrin monomer was done by use of a chromogenic substrate (S-2390, Coa set fibrin monomer). Samples from DIC prone patients with the underlying disease were assayed and classified into four groups. The pre DIC group showed higher FM values than the control with no laboratory coagulation abnormality, although the FDP . D-dimer showed no significant rise. FM assay is a useful marker for the detection of early coagulopathy in DIC. Administration of the AT III concentrate in the case of low level of plasma ATIII, thrombin . antithrombin complex I (TAT) caused a significant transient rise. The clinical course of DIC by TAT is often affected by the fluctuation of ATIII level in plasma, the usefulness of FM is that it reflects the real thrombin generation in DIC.
Insights
Fibrin monomer (FM) assays detect early coagulopathy in disseminated intravascular coagulation (DIC) before other markers rise. FM reflects actual thrombin generation, offering a more reliable indicator than TAT in DIC patients.
Area of Science:
- Coagulation science
- Hematology
- Biochemistry
Context:
- Disseminated intravascular coagulation (DIC) is a complex hematological disorder.
- Early detection of DIC is crucial for effective management.
- Traditional markers like FDP and D-dimer may not show significant changes in early stages.
Purpose:
- To evaluate the utility of a quantitative fibrin monomer (FM) assay in detecting early coagulopathy in patients prone to DIC.
- To compare the sensitivity of FM assay with established markers like FDP and D-dimer.
- To assess the impact of Antithrombin III (AT III) concentrate administration on FM and thrombin-antithrombin complex (TAT) levels.
Summary:
- A chromogenic substrate assay (S-2390) was used to quantify fibrin monomer (FM).
- Patients prone to DIC were grouped, with the pre-DIC group showing elevated FM levels compared to controls, while FDP and D-dimer remained unchanged.
- Administration of AT III concentrate in cases of low plasma ATIII led to a transient rise in TAT, highlighting FM's ability to reflect real-time thrombin generation.
Impact:
- FM assay serves as a valuable marker for the early detection of coagulopathy in DIC.
- FM assay provides a more accurate reflection of thrombin generation compared to TAT, which can be influenced by fluctuating ATIII levels.
- This research contributes to improved diagnostic strategies for DIC, potentially leading to earlier intervention and better patient outcomes.