Fibrinogen in DIC

Q: Normal fibrinogen level in DIC is a good prognostic feature. 

A) True 

B) False 

Answer: B 

Disseminated intravascular coagulation (DIC) is a symptom of the underlying disease, and severity usually correlates with the underlying disease's severity. It is marked by abnormalities such as 

• prolonged PT and aPTT 
• low fibrinogen
• increased D-dimer 
• low platelet count 
• microangiopathic hemolytic anemia (MAHA) on blood smear. 

Fibrinogen is an acute-phase reactant. In sepsis, malignancy, and other inflammatory conditions may have markedly increased fibrinogen production; thus, a plasma fibrinogen level within the normal range may represent a severe underlying process.

 #hematology 

References:

1. Papageorgiou C, Jourdi G, Adjambri E, Walborn A, Patel P, Fareed J, Elalamy I, Hoppensteadt D, Gerotziafas GT. Disseminated Intravascular Coagulation: An Update on Pathogenesis, Diagnosis, and Therapeutic Strategies. Clin Appl Thromb Hemost. 2018 Dec;24(9_suppl):8S-28S. doi: 10.1177/1076029618806424. Epub 2018 Oct 8. PMID: 30296833; PMCID: PMC6710154. 

 2. Kim HK, Lee DS, Kang SH, Kim JQ, Park S, Cho HI. Utility of the fibrinogen/C-reactive protein ratio for the diagnosis of disseminated intravascular coagulation. Acta Haematol. 2007;117(1):34-9. doi: 10.1159/000096786. Epub 2006 Nov 8. PMID: 17095857.