Acquired bleeding disorders

Acquired dysfibrinogenemia

Last author update: 1 June 2010
Last staff update: 10 September 2020

Copyright: 2002-2023,, Inc.

PubMed Search: Acquired dysfibrinogenemia [title]

Kendall Crookston, M.D., Ph.D.
Julie Kim Harrington, M.D.
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Cite this page: Crookston K., Rosenbaum L., Gober-Wilcox J. Acquired dysfibrinogenemia. website. Accessed June 2nd, 2023.
Definition / general
  • Abnormal fibrinogen molecule that causes a decrease in the rate of fibrin polymerization
  • Rarely causes bleeding or thrombosis
  • 80% prevalence in patients with liver disease
  • 8% prevalence in patients with obstructive jaundice
  • Usually caused by liver or biliary tract disease or acute phase reaction
    • Also monoclonal immunoglobulin that binds to fibrinogen
  • Abnormal fibrinogen has increased sialic acid residues, which increases the net negative charge of the molecule, promoting charge repulsion between fibrin monomers, leading to decreased fibrin polymerization
  • In cancer-associated dysfibrinogenemia (hepatocellular carcinoma, cervical carcinoma, breast carcinoma, renal cell carcinoma), tumor cells may secrete abnormal fibrinogen
  • Usually does not cause bleeding or thrombosis, but may in alcoholic liver disease
Clinical features
  • Patients are usually asymptomatic
  • Rarely bleeding or thromboses
  • Screening tests include reptilase time and thrombin time
  • Fibrinogen clotting activity / antigen ratio is confirmatory test
  • Patients usually have abnormal liver function tests
  • Should rule out dysfibrinogenemia in family members (i.e. rule out congenital form)
  • Dysfibrinogenemia typically resolves if underlying disease improves (i.e. liver disease improves or cancer undergoes remission)
Prognostic factors
  • Difficult to assess as patients with liver disease often have coagulation defects that could contribute to bleeding or thrombosis
Case reports
  • Treat clinical findings (i.e. if patient is bleeding, can give cryoprecipitate
  • If patient has thrombosis, can give heparin followed by oral anticoagulants)
Differential diagnosis
  • Autoantibodies against fibrinogen
  • Congenital dysfibrinogenemia
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