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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

Armin J Reininger
1   The Anatomlsches Institut, Technlsche Universltät München, Neuherberg, Germany
,
Cornelia B Reininger
2   The Chirurglsche Klinik und Poliklinik, Neuherberg, Germany
,
Michael Spannagl
3   The Medizinische Klinik Innenstadt, Ludwig-Maximillans-Universität München, Neuherberg, Germany
,
Achim Mellinghoff
3   The Medizinische Klinik Innenstadt, Ludwig-Maximillans-Universität München, Neuherberg, Germany
,
Astrid Porr
1   The Anatomlsches Institut, Technlsche Universltät München, Neuherberg, Germany
,
Ulrich Heinzmann
4   The Institut für Pathologie, GSF-Forschungszentrum, Neuherberg, Germany
,
Laurenz J Wurzinger
1   The Anatomlsches Institut, Technlsche Universltät München, Neuherberg, Germany
› Author Affiliations
Further Information

Publication History

Received 17 November 1994

Accepted after resubmission 18 May 1995

Publication Date:
26 July 2018 (online)

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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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