Effect of Fibrinogen Substitution in Afibrinogenemia on Hemorheology and Platelet Function

Armin J Reininger; Cornelia B Reininger; Michael Spannagl; Achim Mellinghoff; Astrid Porr; Ulrich Heinzmann; Laurenz J Wurzinger

doi:10.1055/s-0038-1649836

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 1995; 74(03): 853-858
DOI: 10.1055/s-0038-1649836

Original Article

Clinical Studies

Schattauer GmbH Stuttgart

Effect of Fibrinogen Substitution in Afibrinogenemia on Hemorheology and Platelet Function

Authors

Armin J Reininger

¹The Anatomlsches Institut, Technlsche Universltät München, Neuherberg, Germany
Cornelia B Reininger

²The Chirurglsche Klinik und Poliklinik, Neuherberg, Germany
Michael Spannagl

³The Medizinische Klinik Innenstadt, Ludwig-Maximillans-Universität München, Neuherberg, Germany
Achim Mellinghoff

³The Medizinische Klinik Innenstadt, Ludwig-Maximillans-Universität München, Neuherberg, Germany
Astrid Porr

¹The Anatomlsches Institut, Technlsche Universltät München, Neuherberg, Germany
Ulrich Heinzmann

⁴The Institut für Pathologie, GSF-Forschungszentrum, Neuherberg, Germany
Laurenz J Wurzinger

¹The Anatomlsches Institut, Technlsche Universltät München, Neuherberg, Germany

Abstract

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Summary

Fibrinogen substitution can correct bleeding in afibrinogenemia. We assessed the effect of fibrinogen substitution in a patient lacking immunoreactive fibrinogen. Fibrinogen and thrombin time were not measurable before, but became detectable within 30 min after substitution, parallelled by an increase in ADP-induced platelet aggregation from <10% to 32%. Platelet adhesion, measured by Stagnation Point Flow Adhesio- Aggregometry, was notdetectable prior to substitution but attained normal values thereafter. Scanning electron microscopy of adhering platelets revealed pseudopodia protrusion and spreading. Morphometry revealed two populations of spread platelets one of which demonstrated inhibited spreading as compared to healthy controls. Immunoelectron microscopy revealed normal GPIIb/IIIa receptor expression, both before and after substitution. Dynamic and kinematic viscosity of plasma and whole blood remained below the 99.9% confidence border of a healthy control group. In afibrinogenemia fibrinogen levels as low as 10% of normal concentration sufficed to normalize coagulation, platelet adhesion, and, partially, spreading.

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References

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