Acquired dysfibrinogenaemia in liver disease

Area of Science:

• Hematology
• Hepatology
• Clinical Chemistry

Background:

• Dysfibrinogenaemia (DF) is a condition affecting blood coagulation.
• Liver diseases can impact fibrinogen function and levels.
• Accurate detection of DF is crucial for patient diagnosis and management.

Purpose of the Study:

• To evaluate a new fibrin monomer polymerisation (FMP) ratio test for detecting dysfibrinogenaemia.
• To determine the incidence of DF in various liver disease patient groups.
• To assess the utility of the FMP test in differentiating hepatocellular and obstructive jaundice.

Main Methods:

• A novel and sensitive screening method, the fibrin monomer polymerisation (FMP) ratio test, was employed.
• The study involved patients diagnosed with cirrhosis, chronic active liver disease, acute liver failure, obstructive jaundice, and miscellaneous liver disorders.
• Standard coagulation tests, including thrombin and Reptilase clotting times, were also analyzed.

Main Results:

• Dysfibrinogenaemia (DF) was detected in a high percentage of patients with severe liver conditions: 76% with cirrhosis, 78% with chronic active liver disease, and 86% with acute liver failure.
• The incidence of DF was significantly lower in patients with obstructive jaundice (8%) and miscellaneous liver disorders (4%).
• Hyperfibrinogenaemia was noted in obstructive jaundice cases, potentially explaining abnormal clotting times despite normal FMP ratios. DF did not correlate with liver function impairment but may relate to hepatic regeneration.

Conclusions:

• The fibrin monomer polymerisation (FMP) ratio test is a simple, sensitive, and effective tool for detecting dysfibrinogenaemia (DF).
• The FMP test is valuable in the differential diagnosis between hepatocellular and obstructive jaundice.
• Dysfibrinogenaemia may be associated with hepatic tissue regeneration rather than the degree of liver function impairment.