The Clinical Significance of Chronic Fibrinaemia

From 1970-1978 we investigated the occurrence of circulating fibrin monomers in 3293 patients in the department of general medicine by means of the aethanol gelation test. Positive tests were found in 151 patients (± 5%). In a variety of diseases (sepsis, meningitis, liver cirrhosis, bleeding with shock, malignancy) the test was only positive for a short time (1 or 2 days).

Of all the patients who had a positive aethanol test for more than two days 33% turned out to have a malignant disease. When fibrin monomers could be detected for more than 5 days (chronic fibrinaemia) the percentage of malignancy rose to 75%! Fibrinaemia was highly correlated (97%) with an elevated level of FDP/fdp. In patients with malignancies and elevated levels of FDP/fdp 20% had clinical signs of thromboembolism. However when this was accompanied by circulating fibrin monomers (more than 5 days) this percentage rose to 45%. Only 12% of patients with chronic fibrinaemia had a bleeding tendency.

 

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