Abstract
The frequent occurrence of abnormal fibrin polymerisation in patients with liver disease has recently been reported. To investigate this further, fibrin polymerisation was studied in 68 patients with cirrhosis or chronic active liver disease. Thirty-three of these patients demonstrated impairment of this phase of blood coagulation. When other tests of liver function were compared in patients demonstrating this abnormality and those in whom fibrin polymerisation was normal, it was found that the former group demonstrated significantly reduced albumin concentrations (p less than 0.0002), raised bilirubin and aspartate aminotransferase levels (p less than 0.0006 and less than 0.003 respectively), and greater prolongation of the one-stage prothrombin time (p less than 0.001) with more marked reduction in factor VII levels (p less than 0.002) compared with the latter patients. It is concluded that defective fibrin polymerisation occurring in patients with liver disease indicates the presence of severely impaired hepatocellular function. This might account for the grave prognosis reported in cirrhotic patients with abnormal fibrin polymerisation who also suffer bleeding from gastro-oesophageal varices.
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- Aiach M., Rogé J., Busy M. F., Durand H., Guéroult N., Chanrion C., Leclerc M., Justin-Besançon L. Dysfibrinogénémies acquises et affections hépatiques. A propos de 30 observations. Sem Hop. 1973 Jan 14;49(3):183–197. [PubMed] [Google Scholar]
- Barr R. D., Ouna N., Simpson J. G., Bagshawe A. F. Dysfibrinogenaemia and primary hepato-cellular carcinoma. Q J Med. 1976 Oct;45(180):647–659. [PubMed] [Google Scholar]
- Donaldson G. W., Davies S. H., Darg A., Richmond J. Coagulation factors in chronic liver disease. J Clin Pathol. 1969 Mar;22(2):199–204. doi: 10.1136/jcp.22.2.199. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dymock I. W., Tucker J. S., Woolf I. L., Poller L., Thomson J. M. Coagulation studies as a prognostic index in acute liver failure. Br J Haematol. 1975 Mar;29(3):385–395. doi: 10.1111/j.1365-2141.1975.tb01836.x. [DOI] [PubMed] [Google Scholar]
- Green G., Poller L., Thomson J. M., Dymock I. W. Factor VII as a marker of hepatocellular synthetic function in liver disease. J Clin Pathol. 1976 Nov;29(11):971–975. doi: 10.1136/jcp.29.11.971. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Green G., Thomson J. M., Dymock I. W., Poller L. Abnormal fibrin polymerization in liver disease. Br J Haematol. 1976 Nov;34(3):427–439. doi: 10.1111/j.1365-2141.1976.tb03589.x. [DOI] [PubMed] [Google Scholar]
- Green G., Thomson J. M., Poller L., Dymock I. W. Proceedings: Abnormal fibrin monomer polymerization in liver disease. Gut. 1975 Oct;16(10):827–827. [PubMed] [Google Scholar]
- HALLEN A., NILSSON I. M. COAGULATION STUDIES IN LIVER DISEASE. Thromb Diath Haemorrh. 1964 Apr 15;11:51–63. [PubMed] [Google Scholar]
- INGRAM G. I., MATCHETT M. O. A rapid "side-room" method for the determination of plasma fibrinogen concentration as fibrin. J Clin Pathol. 1960 Nov;13:469–474. doi: 10.1136/jcp.13.6.469. [DOI] [PMC free article] [PubMed] [Google Scholar]
- MILLER L. L., BALE W. F. Synthesis of all plasma protein fractions except gamma globulins by the liver; the use of zone electrophoresis and lysine-epsilon-C14 to define the plasma proteins synthesized by the isolated perfused liver. J Exp Med. 1954 Feb;99(2):125–132. doi: 10.1084/jem.99.2.125. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Poller L., Thomson J. M., Sear C. H., Thomas W. Identification of a congenital defect of factor VII in a colony of beagle dogs: the clinical use of the plasma. J Clin Pathol. 1971 Oct;24(7):626–632. doi: 10.1136/jcp.24.7.626. [DOI] [PMC free article] [PubMed] [Google Scholar]
- von Felten A., Straub P. W., Frick P. G. Dysfibrinogenemia in a patient with primary hepatoma. First observation of an acquired abnormality of fibrin monomer aggregation. N Engl J Med. 1969 Feb 20;280(8):405–409. doi: 10.1056/NEJM196902202800802. [DOI] [PubMed] [Google Scholar]