How low is the risk of fibrinogen in children

Childhood fibrinogen levels below 1.0g/L are considered dangerous and may pose a risk of bleeding. Low fibrinogen is mainly related to congenital deficiency, liver disease, disseminated intravascular coagulation, severe infections, drug effects, and other factors.

1. Congenital deficiency:

Hereditary hypofibrinogenemia or non fibrinogenemia is a rare cause, and umbilical cord bleeding or mucosal bleeding can occur in children after birth. Diagnosis needs to be confirmed through genetic testing, and treatment mainly involves infusion of fibrinogen concentrate. In severe cases, preventive replacement therapy is required.

2. Liver diseases:

Severe liver diseases such as hepatitis and cirrhosis can lead to a decrease in synthesis function, and fibrinogen levels gradually decrease as liver function deteriorates. Often accompanied by jaundice and prolonged prothrombin time, liver protection treatment is needed to improve the primary disease, and exogenous fibrinogen should be supplemented if necessary.

3. Diffuse intravascular coagulation:

During DIC, fibrinogen is consumed in large quantities, and the level can sharply drop below 0.5g/L, manifested as multiple site bleeding accompanied by shock. Urgent treatment of the primary cause is required, along with supplementation of coagulation factors and platelets. In severe cases, continuous monitoring of coagulation function is necessary.

4. Severe infection:

Severe infections such as sepsis can activate the coagulation system, leading to a decrease in fibrinogen depletion. The child may develop bruising in addition to fever, and requires active anti infective treatment and dynamic monitoring of coagulation indicators. If necessary, fresh frozen plasma should be infused.

5. Drug effects:

Anticoagulants such as heparin and thrombolytic drugs such as urokinase may interfere with fibrinogen function. During medication, it is necessary to regularly test the four coagulation parameters. If any abnormalities occur, the dosage should be adjusted or the medication should be suspended in a timely manner to avoid spontaneous bleeding. For children with low levels of fibrinogen, it is necessary to avoid vigorous exercise and trauma in daily life. The diet can be supplemented with green leafy vegetables rich in vitamin K such as spinach and broccoli, as well as high protein foods such as fish and soy products to promote liver synthesis function. Regularly check coagulation function, and seek medical attention immediately if there is unexplained bruising, nosebleeds, or gum bleeding. Premature infants and children with a family history of bleeding are recommended to be included in high-risk management and undergo comprehensive coagulation screening after birth.