Fibrinogen Level Of 1.6g/L – Causes And Management

Fibrinogen is a large molecular weight protein synthesized by the liver that plays a crucial role in the blood clotting process. The normal range for fibrinogen is between 2-4g/L. A level of 1.6g/L indicates a deficiency, which can result from either non-pathological or pathological factors. This includes conditions such as primary fibrinolysis, hepatitis, cirrhosis, and disseminated intravascular coagulation (DIC).

Non-Pathological Factors
If a patient has recently taken thrombolytic medications like urokinase or streptokinase, these can activate plasminogen into plasmin, leading to the breakdown of fibrinogen. This often results in a reduced level such as 1.6g/L. In most cases, fibrinogen levels return to normal after discontinuation of the medication, and no specific treatment is required.

Pathological Causes

1. Primary Fibrinolysis
This condition occurs when the fibrinolytic system becomes abnormally active, leading to premature and excessive breakdown of fibrinogen and other clotting factors. Patients may be prescribed anti-fibrinolytic drugs such as aminocaproic acid, tranexamic acid, or aprotinin under medical supervision.

2. Hepatitis
Hepatitis is an inflammation of the liver caused by various agents including viruses, bacteria, parasites, alcohol, drugs, chemicals, or autoimmune disorders. Symptoms include fatigue, nausea, loss of appetite, aversion to fatty foods, abdominal bloating, dark urine, and jaundice. Liver damage can impair its ability to produce fibrinogen. Treatment options may include antiviral medications like entecavir or tenofovir as directed by a physician.

3. Cirrhosis
Cirrhosis develops from widespread liver cell necrosis, leading to fibrosis, the formation of nodules and pseudo-lobules, and disruption of normal liver architecture and blood flow. This impairs the liver's capacity to synthesize fibrinogen, resulting in reduced levels. As the disease progresses, patients may develop complications such as circulatory disturbances, splenomegaly, ascites, and jaundice. Treatment may involve liver-protective agents like reduced glutathione or silymarin, and in advanced cases, liver transplantation may be considered.

4. Disseminated Intravascular Coagulation (DIC)
DIC is commonly triggered by severe infections and is characterized by widespread microthrombi formation throughout the body. This leads to excessive consumption of clotting factors, including fibrinogen. Symptoms include bleeding, shock, organ dysfunction, and anemia. Treatment typically includes anticoagulants like heparin and supportive therapies such as anisodamine and dextran, as advised by a healthcare provider.

Individuals with a fibrinogen level of 1.6g/L should promptly visit a general internal medicine department for coagulation function tests and platelet count assessments to determine the underlying cause and prevent further complications. Early diagnosis and appropriate intervention are essential to manage the condition effectively.