What does it mean that the four fibrinogen levels in coagulation are low?

Low levels of fibrinogen in the four coagulation factors usually indicate that the fibrinogen content in the blood is below the normal range, which may be caused by factors such as liver disease, genetic abnormalities, consumptive coagulation disease, drug effects, or malnutrition. Fibrinogen is a key protein in the coagulation process, and a decrease in its level may lead to bleeding tendency or coagulation dysfunction.

1. Liver diseases

Chronic hepatitis, cirrhosis and other liver diseases may lead to a decrease in fibrinogen synthesis. The liver is the main organ for synthesizing fibrinogen, and its synthesis ability decreases when liver function is impaired. Patients may experience symptoms such as fatigue and jaundice. The treatment should be targeted at the primary disease, such as using compound glycyrrhizin tablets, silibinin capsules and other hepatoprotective drugs. In severe cases, fibrinogen preparations need to be infused.

2. Hereditary Abnormalities

Hereditary hypofibrinogenemia is a rare disease caused by mutations in the FGA, FGB, or FGG genes. Patients may experience mild bleeding symptoms from a young age, such as nosebleeds or subcutaneous bruising. Diagnosis requires genetic testing, and treatment mainly focuses on preventing bleeding. In case of acute bleeding, cold precipitation or fibrinogen concentrate can be administered.

3. Consumable coagulation disease

Diffuse intravascular coagulation, severe trauma, or major surgery can lead to excessive depletion of fibrinogen. At this time, in addition to a decrease in values, it is often accompanied by thrombocytopenia and prolonged clotting time. Urgent treatment of the primary disease is required, such as using injection grade Agkistrodon acutus thrombin to stop bleeding, while supplementing coagulation factors.

4. Drug Effects

Long term use of fibrinolytic drugs such as streptokinase and urokinase may degrade fibrinogen. This type of situation requires monitoring of coagulation function and adjusting medication regimen if necessary. For patients with thrombotic diseases, it may be considered to switch to more specific thrombolytic agents such as alteplase.

5. Malnutrition

Severe protein deficiency or insufficient intake of vitamin K may affect fibrinogen synthesis. Commonly seen in patients with long-term vegetarianism and digestive and absorption disorders. Need to improve dietary structure, increase intake of fish, meat, eggs, and milk, and supplement vitamin K1 injection or oral dosage form if necessary. When fibrinogen is found to be low, it should be comprehensively judged in combination with other coagulation indicators to avoid intense exercise and prevent traumatic bleeding. Increase the intake of high-quality protein and green leafy vegetables in diet, and regularly check coagulation function. If accompanied by symptoms such as gum bleeding and increased menstrual flow, it is necessary to seek timely medical attention from a hematology department to investigate the cause. Pregnant women with abnormal indicators need special attention as it may increase the risk of postpartum hemorrhage.