- Blue top tube (3.2% sodium citrate)
- 5 mL of venous blood
Additional information
- Prevent venous stasis by avoiding prolonged tourniquet placement for more than a minute
- Handle sample gently to prevent hemolysis
- Send the sample to the lab immediately
- The fibrinogen assay measures the concentration of soluble factor I (fibrinogen) in blood, before it turns into insoluble fibrin and is crosslinked into a fibrin net
- Fibrinogen is a plasma glycoprotein synthesized in the liver
- Fibrinogen is a coagulation factor converted to fibrin by thrombin, which combines with platelets to form a hemostatic plug in the common final pathway of the coagulation cascade system
- In healthy individuals, there is no residual fibrinogen left in serum after clotting has occurred
- Fibrinogen is also an acute-phase protein reactant, elevated in conditions involving tissue damage and inflammation
- The clinical utility of the fibrinogen assay include:
- Evaluation of bleeding and clotting disorders caused by fibrinogen abnormalities (part of a coagulation panel)
- Aids in the diagnosis of disseminated intravascular coagulation (DIC)
- Evaluation of congenital or acquired dysfibrinogenemias
- Monitor hemostasis in disorders associated with low fibrinogen levels such as liver disease
- Evaluation of elevated fibrinogen levels that can predispose patients to excessive thrombosis
- Evaluation of a given patient's risk of developing cardiovascular disease
- Aids in the diagnosis of placental abruption
- Very high values (>700 mg/dL) are suggestive of significant risk for coronary artery and cerebrovascular disease
- Very low values (<50 mg/dL) can result in hemorrhage after traumatic surgery
Additional information
- Fibrinogen has a half-life of about 4 days
- Factors interfering with test results include:
- High levels of heparin
- High AT-III levels lowers the fibrinogen
- High fibrinogen split product (FSP) levels lower the fibrinogen
- Placement of the tourniquet for longer than 1 minute can result in venous stasis
- Other factors known to affect fibrinogen assay results include:
- Patients with active bleeding
- Acute infection or illness
- Individuals who have received blood transfusions within past 4 wks
- Related laboratory tests include:
- Activated partial thromboplastin time (aPTT)
- Alanine aminotransferase
- Albumin
- Alkaline phosphatase
- Aspartate aminotransferase
- Bilirubin
- Clot retraction
- D-dimer
- Erythrocyte sedimentation rate (ESR)
- Fibrin degradation products
- g-glutamyl transpeptidase
- Liver biopsy
- Plasminogen
- Prothrombin time (PT)
- Thrombin time (TT)
Consult your laboratory for their normal ranges as these may vary somewhat from the ones listed below.
| Conv. Units (mg/dL) | SI Units (g/L) | |
|---|---|---|
| Adult normal range | 200-450 | 2-4.5 |
| Adult critical (high) | >700 | >7 |
| Adult critical (low) | <100 | <1 |
| Newborn | 125-300 | 1.25-3 |
Conditions associated with elevated plasma fibrinogen levels include:
- Inflammation and infection
- Rheumatoid arthritis
- Pneumonia
- Tuberculosis
- Membranoproliferative glomerulonephritis
- Tissue necrosis
- Acute myocardial infarction
- Nephrotic syndrome
- Malignancies
- Multiple myeloma
- Hodgkin's disease
- Stomach cancer
- Breast carcinoma
- Nephrotic carcinoma
- Pregnancy
- Eclampsia
- Stroke
- Smoking
- Older Age
- Drugs
- Acetylsalicylic acid
- Bicalutamide
- Chemotherapeutic drugs
- Estropipate
- Fluvastatin
- Gemfibrozil
- Lovastatin
- Norethandrolone
- Oral contraceptives
- Oxandrolone
- Oxymetholone
- Pyrazinamide
- Streptomycin
Conditions associated with decreased plasma fibrinogen levels include:
- Liver disease
- Disseminated Intravascular Coagulopathy (DIC)
- Hemorrhage
- Malignancies
- Prostate
- Pancreas
- Lung
- Primary fibrinolysis
- Bone marrow lesions
- Extracorporeal circulation
- Afibrinogenemia
- Dysfibrinogenemia
- Hypofibrinogenemia
- Malnutrition
- Rapid large volume blood transfusion (stored blood losses fibrinogen)
- Drugs and substance
- 5-fluorouracil
- Alteplase
- Anabolic steroids
- Anistreplase
- Asparaginase
- Atenolol
- Bezafibrate
- Cefamandole
- Clofibrate
- Dextran
- Factor VIIA
- Fenofibrate
- Fish oils
- Gemfibrozil
- Iron
- Kanamycin
- Lamotrigine
- Lovastatin
- Medroxyprogesterone
- Pegaspargase
- Pentoxifylline
- Phosphorus
- Pravastatin
- Prednisone
- Raloxifene
- Reteplase
- Simvastatin
- Streptokinase
- Sulfisoxazole
- Tenecteplase
- Thrombolytics
- Ticlopidine
- Valproic acid
- Akakura N et al. The COOH-Terminal Globular Domain of Fibrinogen {gamma} Chain Suppresses Angiogenesis and Tumor Growth. Cancer Res. 2006 Oct 1;66(19):9691-7.
- LabTestsOnline®. Fibrinogen. [Homepage on the Internet]© 2001-2006. Last reviewed on December 27, 2004. Last accessed on October 9, 2006. Available at URL: http://www.labtestsonline.org/understanding/analytes/fibrinogen/test.html
- Lippi G et al. Short-term venous stasis influences routine coagulation testing. Blood Coagul Fibrinolysis. 2005 Sep;16(6):453-8.
- Maksimowicz-McKinnon K et al. Predictors of Carotid Atherosclerosis in Systemic Lupus Erythematosus. J Rheumatol. 2006 Oct 1; [Epub ahead of print].
- Morange PE et al. Haemostatic Factors and the Risk of Cardiovascular Death in Patients With Coronary Artery Disease. The AtheroGene Study. Arterioscler Thromb Vasc Biol. 2006 Oct 5; [Epub ahead of print].
- Selmeci L et al. Human blood plasma advanced oxidation protein products (AOPP) correlates with fibrinogen levels. Free Radic Res. 2006 Sep;40(9):952-8.
- Suontaka AM et al. Changes in functional activities of plasma fibrinogen after treatment with methylene blue and red light. Transfusion. 2003 May;43(5):568-75.
- UTMB Laboratory Survival Guide®. Fibrinogen. [Homepage on the Internet]© 2006. Last reviewed in December 2006. Last accessed on December 11, 2006. Available at URL: http://www.utmb.edu/lsg/LabSurvivalGuide/hem/fibrinogen.htm
- Von Kanel R et al. Altered blood coagulation in patients with post-traumatic stress disorder. Psychosom Med. 2006 Jul-Aug;68(4):598-604.
- Wang Q et al. [Clinical significance of plasma fibrinogen level in patients with colorectal cancer] [Article in Chinese]. Zhonghua Zhong Liu Za Zhi. 2005 Sep;27(9):544-6.