Is there a relationship between low levels of fibrinogen in children

Low levels of fibrinogen in children are mostly due to physiological fluctuations, which may be related to metabolic changes during growth and development, temporary malnutrition, viral infections, mild liver dysfunction, or genetic factors. Comprehensive evaluation should be conducted in conjunction with other indicators of coagulation function.

1. Growth and development factors:

When children are in a period of rapid growth, plasma volume expansion may lead to a relative decrease in fibrinogen concentration. This physiological dilution phenomenon is common in school-age children with rapid height and weight gain, usually accompanied by a mild decrease in hemoglobin, while other coagulation function indicators such as PT and APTT remain within normal ranges.

2. Insufficient nutrient intake:

Long term picky eating or insufficient protein intake can affect the liver's ability to synthesize fibrinogen. When lacking essential amino acids such as lysine and tryptophan, fibrinogen values may be slightly lower than the lower limit of the reference range, accompanied by lower total protein and albumin indicators.

3. Impact of viral infection: During respiratory or intestinal viral infections, inflammatory factors temporarily inhibit liver synthesis function. After infection with common pathogens such as EB virus and rotavirus, there may be a transient decrease in fibrinogen, which usually gradually returns to normal levels within 2-4 weeks of recovery.

4. Abnormal liver function:

Mild fatty liver or drug-induced liver injury can affect the efficiency of fibrinogen synthesis. When the alanine aminotransferase (ALT) exceeds 80U/L, it may be accompanied by a decrease in fibrinogen, and further liver ultrasound examination is needed to rule out biliary tract diseases.

3. Genetic factors:

Very few cases of congenital hypofibrinogenemia belong to autosomal dominant genetic diseases. These children often have a family history of bleeding, with fibrinogen levels consistently below 1.0g/L, and need to be diagnosed through genetic testing. They should avoid strenuous exercise and trauma in their daily lives. When children have low levels of fibrinogen, it is recommended to prioritize supplementing high-quality protein through dietary adjustments and ensuring daily intake of eggs, fish, soy products, etc. Moderate increase in kiwifruit, citrus and other fruits with high vitamin C content to promote iron absorption. Avoid vigorous exercise to prevent bruising and bleeding, and recheck coagulation function 2-3 months later. If accompanied by symptoms such as skin bruising, nosebleeds, or continuous decline in follow-up indicators, it is necessary to promptly go to the hematology department for a complete set of coagulation factor tests. Pay attention to observing whether children have abnormal symptoms such as prolonged wound hemostasis time and joint swelling in daily life, and proactively inform the doctor of their coagulation function before vaccination.