Plasma fibronectin concentration in patients with acquired consumptive coagulopathies

Plasma fibronectin was assayed in 179 hospitalized patients referred for workup of possible acquired coagulopathy. Based on laboratory results and chart review, these patients were classified as having no coagulopathy (N = 36), defibrination syndrome (N = 31), compensated defibrination syndrome (N = 100), microangiopathic thrombocytopenia (N = 7), and primary fibrinolysis (N = 5). Compared to patients with no coagulopathy, fibronectin concentration was reduced in patients with defibrination syndrome (p less than 0.005) and compensated defibrination syndrome (p less than 0.10). Fibronectin concentration was not reduced in patients with microangiopathic thrombocytopenia and primary fibrinolysis. In patients with defibrination syndrome, the reduction of fibronectin was correlated to the degree of liver impairment. This finding is consistent with the liver being the primary site of synthesis of plasma fibronectin. Fibronectin was significantly correlated to plasminogen and antithrombin III. The sensitivity of fibronectin for the diagnosis of coagulopathy is low except for patients with defibrination syndrome.