Comparison of the fibrinogen Clauss assay and the fibrinogen PT derived method in patients with dysfibrinogenemia

Miesbach, Wolfgang; Schenk, J.; Alesci, S.; Lindhoff-Last, Edelgard

doi:10.1016/j.thromres.2010.09.004

Cited by 104 publications

(84 citation statements)

References 17 publications

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“…There are several approaches for measuring fibrinogen assays including determination of the amount of fibrin generated by thrombus formation, assessing for the amount of fibrinogen antigen present, or the actual measurement of fibrinogen protein in plasma samples. 8,9,26 Fibrinogen levels derived from the Clauss method are generally lower than PT-derived fibrinogen levels, 9 and this was corroborated in this study (Table 1). 7 This method measures fibrinogen levels generated in a diluted plasma sample in the presence of excess thrombin.…”

Section: Discussionsupporting

confidence: 80%

Fibrinogen Measurements in Plasma and Whole Blood

Ogawa

Tanaka

Nakajima³

et al. 2015

Anesthesia &Amp; Analgesia

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Section: Discussionsupporting

confidence: 80%

Fibrinogen Measurements in Plasma and Whole Blood

Ogawa

Tanaka

Nakajima³

et al. 2015

Anesthesia &Amp; Analgesia

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“…Reported overestimations of functional and antigenic fibrinogen values depend on the type of assay. 40 The most sensitive tests are the TT and RT, 21 although in some exceptional cases most coagulation parameters are normal and only genotyping can confirm the diagnosis. To date about 100 mutations resulting in CD are documented.…”

Section: Discussionmentioning

confidence: 99%

Natural history of patients with congenital dysfibrinogenemia

Casini

Blondon

Lebreton

et al. 2015

Blood

135

170

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Key Points• Major bleeding, thrombosis, and postpartum hemorrhage are frequent in propositi and relatives with congenital dysfibrinogenemia.• Hotspot mutations were not predictive of either phenotype or outcome.We conducted a multicenter study of 101 patients with congenital dysfibrinogenemia (CD) to characterize the incidence of hemorrhagic and thrombotic events as well as complications of pregnancy and surgery. At the time of diagnosis, 10.9% and 13.9% had experienced major bleeding and thrombotic events, respectively. During a mean followup of 8.8 years after CD diagnosis, the incidence of major bleeding and thrombotic events was 2.5 and 18.7 per 1000 patient-years, respectively, with estimated cumulative incidences at age 50 years of 19.2% and 30.1%. We identified 111 pregnancies with an overall incidence of spontaneous abortions and postpartum hemorrhage of 19.8% and 21.4%, respectively. The risk of postpartum hemorrhage was associated with a previously identified bleeding phenotype (odds ratio, 5.8; 95% CI, 1.2 to 28.0). Among 137 surgical procedures analyzed, 9 (6.5%) were complicated by abnormal bleeding. Propositi vs relatives, sex, mutation hotspots, fibrinogen levels, and activity:antigen ratios were not associated with the risk of thrombotic or bleeding outcomes. In conclusion, the results of our study, the largest in genotyped CD and the first including long-term history, indicate that propositi with CD and their relatives carry not only a high risk of major bleeding, including postpartum hemorrhage, but also of thrombotic event. (Blood. 2015;125(3):553-561) Medscape Continuing Medical Education online This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medscape, LLC and the American Society of Hematology. Medscape, LLC is accredited by the ACCME to provide continuing medical education for physicians. Medscape, LLC designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test with a 75% minimum passing score and complete the evaluation at http://www.medscape.org/journal/blood; and (4) view/print certificate. For CME questions, see page 581. Disclosures The authors, Associate Editor José A. López, and CME questions author Laurie Barclay, freelance writer and reviewer, Medscape, LLC, declare no competing financial interests. Learning objectives1. Describe complications of major bleeding and thrombosis in persons with congenital dysfibrinogenemia (CD) and their affected relatives.2. Identify complications of pregnancy and surgery in persons with CD and their affected rela...

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“…Prothrombin time-based fibrinogen assays can generate falsely high fibrinogen results depending on the type of thromboplastin used and the patient's underlying condition. 11,12 For example, PT-based assays can overestimate fibrinogen results in patients with and without dysfibrinogenemia, 13,14 and can disagree with Clauss-based assays in patients with low fibrinogen. 13,15 One study even concluded that some PT-based fibrinogen assays were clinically unsafe.…”

Section: Grading Of Fibrinogen Assaysmentioning

confidence: 99%

External Quality Assurance of Fibrinogen Assays Using Normal Plasma: Results of the 2008 College of American Pathologists Proficiency Testing Program in Coagulation

Cunningham

Olson

Chandler

et al. 2012

Archives of Pathology &Amp; Laboratory Medicine

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N Context.-Proper diagnosis and therapy of fibrinogen deficiency requires high-quality fibrinogen assays.Objective.-To assess the interlaboratory bias, precision, and grading of fibrinogen assays used by laboratories participating in the United States College of American Pathologists proficiency testing program in coagulation.Design.-Two identical vials of normal plasma were sent to more than 3500 laboratories. Participants measured fibrinogen levels using local methods.Results.-Fifty different fibrinogen methods were evaluated. All-method bias was 8.3% (range of method-specific biases, 0.0%-27.0%) and all-method coefficient of variation was 7.7% (range of method-specific coefficients of variation, 0.7%-25.8%). After controlling for reagent/instrument type, mean fibrinogen levels were 11.6% higher for prothrombin time-based reagents compared to Clauss (P , .001), and coefficient of variation was 46% lower for mechanical endpoint instruments compared to photo-optical. Most testing events (97.4%) could be reliably graded as pass or fail using a target range of 620% from the method mean (total pass rate, 98.8%). Total fail rate was 3.0-fold lower for mechanical instruments compared to photo-optical (0.5% versus 1.5%, P = .001). Nonetheless many photo-optical methods had very high precision and very low fail rates.Conclusions.-Fibrinogen assays showed highly variable methodology and performance characteristics. Bias, precision, and grading were affected by the type of reagent or instrument used.

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Comparison of the fibrinogen Clauss assay and the fibrinogen PT derived method in patients with dysfibrinogenemia

Cited by 104 publications

References 17 publications

Fibrinogen Measurements in Plasma and Whole Blood

Fibrinogen Measurements in Plasma and Whole Blood

Natural history of patients with congenital dysfibrinogenemia

External Quality Assurance of Fibrinogen Assays Using Normal Plasma: Results of the 2008 College of American Pathologists Proficiency Testing Program in Coagulation

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