Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.727
Index Copernicus  – 166.39
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2016, vol. 25, nr 6, November-December, p. 1255–1263

doi: 10.17219/acem/65781

Publication type: original article

Language: English

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Assessment of Selected ROTEM Parameters, Kinetics of Fibrinogen Polymerization and Plasmin Amidolytic Activity in Patients with Congenital Fibrinogen Defects

Jacek Treliński1,2,A,B,C,D,E,F, Katarzyna Pachniewska2,B,C,E,F, Justyna Matczak3,B,C,F, Paweł Nowak3,B,F, Marta Robak2,B,C,E,F, Krzysztof Chojnowski2,A,B,C,D,E,F

1 Department of Hematology, Medical University of Łódź, Poland

2 Department of Hemostasis, Medical University of Łódź, Poland

3 Department of General Biochemistry, Faculty of Biology and Environmental Protection, University of Łódź, Poland

Abstract

Background. Congenital fibrinogen disorders (CFD) are rare fibrinogen deficiencies which may be quantitative or functional. The clinical course of hypofibrinogenemia (hypoFI) or dysfibrinogenemia (dysFI) is unpredictable and cannot be determined by the application of standard hemostasis tests.
Objectives. The main aim of this study was to assess ROTEM parameters in CFD patients.
Material and Methods. Nine patients with CFD were studied. The fibrinogen concentration was measured functionally and antigenically. EXTEM, INTEM, FIBTEM and APTEM tests were used to measure selected ROTEM parameters, including maximum clot firmness (MCF). Fibrin plasma polymerization, clot lysis and plasmin amidolytic activity were determined by spectrophotometric methods.
Results. Incorporating the antigenic, ELISA method, to the diagnostic workup allowed the initial diagnosis to be switched from hypoFI to dysFI in 3/7 patients. MCF readings (the most important parameter describing fibrin polymerization capacity) were significantly lower in patients than in controls according to all ROTEM tests. Cases with hypoFI demonstrated markedly lower readings of MCF according to all ROTEM tests than cases with dysFI. All patients demonstrated disturbances of fibrin polymerization process assessed by turbidimetry. In contrast, no marked differences were identified between studied groups in reference to plasmin amidolytic activity.
Conclusion. Our data suggests that ROTEM and fibrin plasma polymerization according to the turbidimetric method have a high sensitivity towards detection of different CFD. Although ROTEM MCF assessment may help discriminate patients with hypoor dysfibrinogenemia, this finding has to be confirmed on larger groups of patients.

Key words

ROTEM, congenital fibrinogen disorders, fibrin plasma polymerization by turbidimetric method

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