Background: The conventional method for determining plasma fibrinogen levels, such as the Clauss fibrinogen test based on plasma clotting reactions, is widely practiced globally. Despite its common use, this test is susceptible to interference from fibrinolytic products like fibrin degradation products (FDPs). While this interference may not significantly impact results for normal individuals, it poses a substantial challenge in clinical scenarios, particularly in cases of bleeding complications.
In situations where low fibrinogen levels are detected, distinguishing whether this is a genuine indication of low fibrinogen or a result of interference from hyperfibrinolysis becomes crucial. This distinction is paramount in guiding appropriate treatment strategies, as the approach to managing bleeding differs significantly based on the underlying cause.
Aims: To address this challenge and refine treatment strategies, a novel fibrinogen test has been developed.
Methods: The test, detailed in previous ISTH posters, has been systematically evaluated in the presence of varying concentrations of FDPs, which are known clot-inhibiting metabolites. In contrast to the conventional clotting reaction, this test demonstrates no interference from FDPs, allowing for a more accurate assessment of fibrinogen levels in the presence of fibrinolytic products.
Results: Comparative studies with the Clauss fibrinogen test, utilizing samples from a group of healthy donors, yielded surprising results. Some individuals, previously identified with lower Clauss fibrinogen levels, were found to have higher levels using the new test, with differences exceeding 1 g/L. The test was further applied to samples from patients with chronic liver disease, revealing fibrinogen levels that exhibited stronger correlation with FV levels.
Conclusion(s): In summary, this novel fibrinogen test, exhibiting enhanced specificity compared to the Clauss fibrinogen test, provides a more accurate estimation of fibrinogen levels in the presence of interfering fibrinolytic products, particularly prevalent in cases of bleeding complications. This advancement holds significant promise for refining clinical assessments and treatment strategies in such scenarios.
