Fibrinogen cirrhosis

Hepatic Effects. Carbon tetrachloride has been known for many years to be a powerful hepatotoxic agent in humans and in animals. The principal clinical signs of liver injury in humans who inhale carbon tetrachloride are a swollen and tender liver, elevated levels of hepatic enzyme (aspartate aminotransferase) in the serum, elevated serum bilirubin levels and the appearance of jaundice, and decreased serum levels of proteins such as albumin and fibrinogen (Ashe and Sailer 1942 McGuire 1932 New et al. 1962 Norwood et al. 1950 Straus 1954). In cases of acute lethal exposures, autopsy generally reveals marked liver necrosis with pronounced steatosis (Jennings 1955 Markham 1967 Smetana 1939), and repeated or chronic exposures leads in some cases to fibrosis or cirrhosis (McDermott and Hardy 1963). 

There are also some acquired dysfibrinogenemias from alterations to fibrinogen, usually as a result of disease processes. Liver disease (including cirrhosis, hepatitis, or hepatic carcinomas) is the most common cause of these modifications. In these cases, there is usually an increase in the sialic acid content of the fibrinogen s carbohydrate (Martinez et al, 1983). 

Latent and compensated forms of consumptive coagulopathy frequently occur in the course of severe acute or chronic liver disease. In 80-85% of cirrhosis patients, the values of at least one basic test (thrombocytes. Quick s value, fibrinogen, AT III, bleeding time) are pathological. In 15-30% of cases, clinically relevant haemorrhagic diathesis evolves. 

While non-specific signs of inflanunation may also be present in liver cirrhosis, they are much more obvious in HCC. For example, positive CRP values as well as an increase in the BSR, a-globulins, aj-antitrypsin and fibrinogen can be found. A constellation of decreased serum iron and elevated serum copper (140) points to a consuming inflammatory process or malignant tumour, (s. tab. 5.10) Usually, the haemogram shows leucocytosis and anaemia. Nitric oxide values in the plasma are elevated in correlation with tumour size. (s. tabs. 37.6, 37.11, 37.12)... 

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