At a Glance
Why Get Tested?
As part of an investigation of a possbile bleeding disorder or thrombotic episode, particularly to evaluate the level and function of fibrinogen; sometimes it is used to help evaluate your risk of developing cardiovascular disease
When to Get Tested?
When you have bleeding or thrombotic episodes; when a PT and/or PTT test is prolonged; when you have a relative with a hereditary fibrinogen deficiency or abnormality; when your doctor wants additional information to help evaluate your risk of developing heart disease
A blood sample drawn from a vein in your arm or sometimes via fingerstick
Test Preparation Needed?
The Test Sample
What is being tested?
Fibrinogen is a coagulation factor (factor I), a protein that is essential for blood clot formation. It is produced by the liver and released into the circulation as needed along with several other clotting factors. Normally, when a body tissue or blood vessel wall is injured, a process called hemostasis begins to form a plug at the injury site to help stop the bleeding. Small cell fragments called platelets adhere to and aggregate at the site, and a coagulation cascade is initiated, with clotting factors being activated one after the other. As the cascade nears completion, soluble fibrinogen is converted into insoluble fibrin threads. These threads crosslink together to form a fibrin net that stabilizes at the injury site. The fibrin net adheres to the site of injury along with the platelets to form a stable blood clot. This barrier prevents additional blood loss and remains in place until the injured area has healed.
There must be an adequate number of platelets and enough of each of the coagulation factors plus each must function normally in order for a stable clot to form. Too little or dysfunctional factors or platelets can lead to bleeding episodes and/or to thrombosis. There are several laboratory tests including fibrinogen tests that can be used to evaluate hemostasis. It is now understood that coagulation tests are based on what happens artificially in the test setting (in vitro) and thus do not necessarily reflect what actually happens in the body (in vivo). Nevertheless, the tests can be used to evaluate specific components of the hemostasis system. (For more on this, see the explanation of the coagulation cascade). The fibrinogen activity test evaluates that part of the hemostatic process in which soluble fibrinogen is converted into fibrin threads. With the addition of thrombin to the test sample, the fibrinogen test bypasses the rest of the coagulation factors and focuses on the function of fibrinogen.
- A fibrinogen activity test measures the time that it takes for a fibrin clot to form following the addition of a standard amount of thrombin to plasma. This test evaluates the function of fibrinogen, its ability to be converted into fibrin. The time that is required for a clot to form directly correlates with the amount of active fibrinogen that is present. Prolonged clot-formation times may be due to decreased concentrations of normal fibrinogen or due to dysfunctional fibrinogen.
- A fibrinogen antigen test uses a fibrinogen antibody to bind to fibrinogen in a blood sample. This test allows the quantity, but not activity, of fibrinogen to be measured.
Fibrinogen is also one of several blood factors that are called acute phase reactants. Blood levels of fibrinogen along with other acute phase reactants rise sharply with conditions causing acute tissue inflammation or damage. Tests for these acute phase reactants, including fibrinogen, may be performed to determine the extent of inflammation in the body.
How is the sample collected for testing?
A blood sample is obtained by inserting a needle into a vein in the arm. Alternatively, particularly in pediatric care, the blood sample is drawn by quickly pricking the fingertip with a lancet.
NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.
Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.
Is any test preparation needed to ensure the quality of the sample?
No test preparation is needed.
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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.
Sources Used in Current Review
Dugdale, D. (Updated 2009 March 2). Fibrinogen. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003650.htm. Accessed September 2010.
Balasa, V. (Updated 2010 July 28). Inherited Abnormalities of Fibrinogen. eMedicine. [On-line information]. Available online at http://emedicine.medscape.com/article/960677-overview through http://emedicine.medscape.com. Accessed September 2010.
Brick, W. et. al. (Updated 2009 November 17). Dysfibrinogenemia. eMedicine. [On-line information]. Available online at http://emedicine.medscape.com/article/199723-overview through http://emedicine.medscape.com. Accessed September 2010.
Dugdale, D. (Updated 2009 March 2). Congenital afibrinogenemia. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/001313.htm. Accessed September 2010.
Spence, R. et. al. (Updated 2010 January 12). Hemostatic Disorders, Nonplatelet eMedicine. [On-line information]. Available online at http://emedicine.medscape.com/article/210467-overview through http://emedicine.medscape.com. Accessed September 2010.
Pagana, K. D. & Pagana, T. J. (© 2007). Mosby's Diagnostic and Laboratory Test Reference 8th Edition: Mosby, Inc., Saint Louis, MO. Pp 458-459.
Wu, A. (© 2006). Tietz Clinical Guide to Laboratory Tests, 4th Edition: Saunders Elsevier, St. Louis, MO. Pp 404-405.
Sources Used in Previous Reviews
Thomas, Clayton L., Editor (1997). Taber's Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition].
Pagana, Kathleen D. & Pagana, Timothy J. (2001). Mosby's Diagnostic and Laboratory Test Reference 5th Edition: Mosby, Inc., Saint Louis, MO. Pp 421-422
Coagulation Test Panels. Clinical and Research Laboratories, Florida Hospital Cancer Institute [On-line information]. Available online at http://www.fhci-labs.com/researchlabs/clinicallabs/hemostasisandthrombosis/panels.htm through http://www.fhci-labs.com.
Elstrom, R. (2001 November 25, Updated). Fibrinogen. MEDLINEplus Health Information, Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003650.htm.
Laposata, M. & Vancott, E. (2000 January). How to work up hypercoagulability. CAP In the News [On-line Coagulation Case Study]. Available online at http://www.cap.org/CAPToday/casestudy/coag5.html through http://www.cap.org.
Bleeding Disorders. The Merck Manual of Medical Information-Home Edition, Section 14. Blood Disorders, Chapter 155 [On-line information]. Available online at http://www.merck.com/mrkshared/mmanual_home/sec14/155.jsp through http://www.merck.com.
Venomous Bites and Stings. The Merck Manual of Medical Information-Home Edition, Section 24. Accidents and Injuries, Chapter 287 [On-line information]. Available online at http://www.merck.com/mrkshared/mmanual_home/sec24/287.jsp through http://www.merck.com.
Joist, (2000 April 19, Revised 4/19/00). What I Need to Know About Thrombophilia. Saint Louis University, Coagulation Consultants [On-line information]. Available online at http://www.slucare.edu/clinical/pathlab/coagulation/thrombophilia.shtml through http://www.slucare.edu.
Menta, S. (1999 Spring). The Coagulation Cascade. Physiology Disorders Evaluation, College of Medicine, Univ of Florida [On-line information]. Available online at http://www.medinfo.ufl.edu/year2/coag/title.html through http://www.medinfo.ufl.edu.
Elstrom, R. (2001 October 21, Updated). Bleeding disorders. MEDLINEplus Health Information, Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/001304.htm.
Elstrom, R. (2001 October 19, Updated). DIC (disseminated intravascular coagulation). MEDLINEplus Health Information, Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/000573.htm.