Fibrinogen deficiency in hemophilia

Abstract

The amount of fibrinogen of the blood seems to vary within wide variations both in man and in animals. In hemophilia there have been some estimations of the percentage of fibrinogen based upon the amount of fibrin obtained after coagulation. However, these data are so divergent as to allow of no satisfactory deduction, quite apart from the fact that they give no information as to the quality of the fibrinogen.

In the estimations of fibrinogen here reported, a functional method has been made use of. Precipitated fibrinogen, made approximately according to the method of Hammarsten, has been added to the whole blood of cases of hemophilia, of purpura, and of normal adults and children. To ten drops of blood, one, two, and three drops of fibrinogen have been added; a fourth tube serving as a control. In this way we are able to ascertain whether the fibrinogen had a complementary action in hemophilia, as compared to the other cases, and also whether it brought the clotting time of the blood close to the normal. In all cases, the fibrinogen had been previously tested with calcium and found not to clot over night upon the addition of a few drops of a 1/2 per cent. solution of calcium chloride. In three cases of typical hereditary hemophilia, repeated tests showed that the addition of one drop of the fibrinogen solution to the whole blood markedly hastened the coagulation time. In one of these instances, a case of severe hemophilia, the clotting time was reduced by fibrinogen in four consecutive tests from 90 to 13 minutes, from 55 to 14 minutes, from 106 to 87 minutes, and from 3 hours to 16 minutes. On the other hand, similar tests of three cases of purpura brought about no such result, the coagulation time remaining either the same or being delayed by the fibrinogen.