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- $Unique_ID{BRK04349}
- $Pretitle{}
- $Title{Afibrinogenemia, Congenital}
- $Subject{Afibrinogenemia Congenital Congenital Afibrinogenemia Factor IX
- Deficiency Factor XIII Deficiency Hageman Factor Deficiency Hemophilia Von
- Willebrand Disease }
- $Volume{}
- $Log{}
-
- Copyright (C) 1993 National Organization for Rare Disorders, Inc.
-
- 940:
- Afibrinogenemia, Congenital
-
- ** IMPORTANT **
- It is possible that the main title of the article (Congenital
- Afibrinogenemia) is not the name you expected. Please check the SYNONYMS
- listing to find the alternate name and disorder subdivisions covered by this
- article.
-
- Synonyms
-
- Congenital Afibrinogenemia
-
- Information on the following diseases can be found in the Related
- Disorders section of this report:
-
- Factor IX Deficiency
- Factor XIII Deficiency
- Hageman Factor Deficiency
- Hemophilia
- Von Willebrand Disease
-
- General Discussion
-
- **REMINDER **
- The Information contained in the Rare Disease Database is provided for
- educational purposes only. It should not be used for diagnostic or treatment
- purposes. If you wish to obtain more information about this disorder, please
- contact your personal physician and/or the agencies listed in the "Resources"
- section of this report.
-
- Congenital Afibrinogenemia is a rare disorder in which the patient is
- born with little or no fibrinogen. Fibrinogen is a protein necessary in the
- blood clotting process. As a result, the blood does not coagulate causing
- the patient to bleed uncontrollably. Many patients may experience severe
- hemorrhaging during childhood while others may have very little trouble with
- bleeding. Congenital Afibrinogenemia is thought to be inherited as an
- autosomal recessive genetic trait.
-
- Symptoms
-
- Congenital Afibrinogenemia is a very rare blood disorder in which the patient
- is born with little or no fibrinogen in the circulating blood. Fibrinogen is
- a protein that is needed to form blood clots. When this protein is absent,
- the blood does not coagulate which can cause the patient to hemorrhage.
-
- Two thirds of the patients with Congenital Afibrinogenemia have bleeding
- problems from infancy on. The severity and frequency of bleeding from
- surgery or trauma can vary from mild to severe.
-
- Infants may have severe hemorrhaging during the first few days of life.
- Typically the hemorrhaging can be noticed from the umbilical cord, in the
- stools, when vomiting, after circumcision, from the use of forceps during
- delivery and/or in collections of blood that become trapped in the skin
- tissue (hematomas).
-
- Other symptoms of Congenital Afibrinogenemia may be severe bleeding after
- minor trauma, the loss of baby teeth, or during the extraction of teeth.
- Patients may also bruise easily and hemorrhage from the gums.
-
- Some patients with Congenital Afibrinogenemia also experience
- hemorrhaging into a joint (hemarthrosis); nosebleeds; gastrointestinal
- bleeding; heavy bleeding during menstruation; bleeding in the chest cavity
- and/or a ruptured spleen.
-
- Causes
-
- Congenital Afibrinogenemia is thought to be inherited as an autosomal
- recessive trait. Human traits, including the classic genetic diseases, are
- the product of the interaction of two genes, one received from the father and
- one from the mother. In recessive disorders, the condition does not appear
- unless a person inherits the same defective gene for the same trait from each
- parent. If one receives one normal gene and one gene for the disease, the
- person will be a carrier for the disease, but usually will not show symptoms.
- The risk of transmitting the disease to the children of a couple, both of
- whom are carriers for a recessive disorder, is twenty-five percent. Fifty
- percent of their children will be carriers, but healthy as described above.
- Twenty-five percent of their children will receive both normal genes, one
- from each parent, and will be genetically normal.
-
- Affected Population
-
- Congenital Afibrinogenemia is a rare disorder that affects males and females
- in equal numbers. Approximately one hundred and thirty cases have been
- recorded in the medical literature.
-
- Related Disorders
-
- Symptoms of the following blood clotting disorders can be similar to those of
- Congenital Afibrinogenemia. Comparisons may be useful for a differential
- diagnosis:
-
- Factor IX Deficiency is a severe genetic bleeding disorder that resembles
- classic Hemophilia A. Factor IX is a component of the blood clotting
- substance thromboplastin. It is deficient at birth in patients with this
- disorder. Factor IX Deficiency varies in severity between families and
- occurs most often among males. In rare instances, female carriers have been
- known to exhibit this deficiency in a mild form. Symptoms include prolonged
- bleeding episodes, and in very severe cases, joint pain and bone deformities.
- (For more information on this disorder, choose "Factor IX Deficiency" as your
- search term in the Rare Disease Database).
-
- Factor XIII Deficiency is a very rare inherited disorder that prevents
- the blood from clotting normally. The lack of clotting factor XIII can cause
- slow, oozing internal bleeding which may begin several days after even a mild
- trauma, such as a bump or bruise. The bleeding may persist so that large
- cysts form in the tissue spaces, destroying the surrounding bone and causing
- peripheral nerve damage. This typically occurs in the thigh and buttocks
- area. (For more information on this disorder, choose "Factor XIII
- Deficiency" as your search term in the Rare Disease Database).
-
- Hageman Factor Deficiency is a rare genetic blood disorder. It is caused
- by a lack in activity of the Hageman factor in blood plasma, a single-chain
- glycoprotein which is also called Factor XII. This factor is needed for
- blood clotting. However, when it is deficient, other blood clotting factors
- tend to compensate for Factor XII. This disorder usually presents no symptoms
- and is only accidentally discovered through pre-operative blood tests that
- are required by hospitals. (For more information on this disorder, choose
- "Hageman Factor Deficiency" as your search term in the Rare Disease
- Database).
-
- Hemophilia is a hereditary blood clotting disorder which affects males
- almost exclusively. Hemophilia is caused by the inactivity of one of the
- blood proteins necessary (usually Factor VIII) for clotting and can be
- classified by its level of severity; mild, moderate, and severe. Severity is
- determined by the percentage of active clotting factor in the blood. (For
- more information on this disorder, choose "Hemophilia" as your search term in
- the Rare Disease Database).
-
- Von Willebrand Disease is a hereditary blood clotting disorder
- characterized by prolonged bleeding. Blood clotting is slow due to a
- deficiency of the Von Willebrand factor protein and factor VIII protein (the
- factor VIII complex). Also, platelets do not stick normally causing
- excessively slow clotting time. Increased risk of excessive bleeding
- following surgery, dental procedures or injury occurs in patients with this
- disorder. With proper treatment and appropriate precautions, few patients
- become seriously handicapped by Von Willebrand Disease. The tendency to
- prolonged bleeding usually decreases with age. (For more information on this
- disorder choose "Von Willebrand" as your search term in the Rare Disease
- Database)
-
- Therapies: Standard
-
- Patients with Congenital Afibrinogenemia may be treated with infusions of
- cryoprecipitate concentrates. This is prescribed to raise the fibrogen level
- in the blood permitting clots to form.
-
- Fibrogen concentrates may be given but there is a risk of contracting an
- infectious disorder. Cryoprecipitate is the preferred treatment.
-
- Genetic counseling may be of benefit for patients and their families.
- Other treatment is symptomatic and supportive.
-
- Therapies: Investigational
-
- Research on birth defects and their causes is ongoing. The National
- Institutes of Health (NIH) is sponsoring the Human Genome Project which is
- aimed at mapping every gene in the human body and learning why they sometimes
- malfunction. It is hoped that this new knowledge will lead to prevention and
- treatment of genetic disorders in the future.
-
- This disease entry is based upon medical information available through
- May 1993. Since NORD's resources are limited, it is not possible to keep
- every entry in the Rare Disease Database completely current and accurate.
- Please check with the agencies listed in the Resources section for the most
- current information about this disorder.
-
- Resources
-
- For more information on Congenital Afibrinogenemia:
-
- National Organization for Rare Disorders (NORD)
- P.O. Box 8923
- New Fairfield, CT 06812-1783
- (203) 746-6518
-
- National Hemophilia Foundation
- 110 Greene St., Suite 303
- New York, NY 10012
- (212) 563-0211
-
- NIH/National Heart Lung & Blood Institute (NHLBI)
- 9000 Rockville Pike
- Bethesda MD 20892
- (301) 496-4236
-
- For Genetic Information and Genetic Counseling Referrals:
-
- March of Dimes Birth Defects Foundation
- 1275 Mamaroneck Avenue
- White Plains, NY 10505
- (914) 428-7100
-
- Alliance of Genetic Support Groups
- 35 Wisconsin Circle, Suite 440
- Chevy Chase, MD 20815
- (800) 336-GENE
- (301) 652-5553
-
- References
-
- MENDELIAN INHERITANCE IN MAN, 9th Ed.: Victor A. McKusick, Editor: Johns
- Hopkins University Press, 1992. Pp. 1199-1200.
-
- CECIL TEXTBOOK OF MEDICINE, 19th Ed.: James B. Wyngaarden, and Lloyd H.
- Smith, Jr., Editors; W.B. Saunders Co., 1990. P. 1073.
-
- HEMATOLOGY, 4TH Ed,: William J. Williams, et al,: Editors; McGraw-Hill,
- Inc. Pp. 1474-5.
-
- BIRTH DEFECTS ENCYCLOPEDIA, Mary Louise Buyse, M.D., Editor-In-Chief;
- Blackwell Scientific Publications, 1990. Pp. 62-3.
-
- PROPHYLACTIC CRYOPRECIPITATE IN CONGENITAL AFIBRINOGENEMIA: R.C.
- Rodriguez, et al.; Clin Pediatr (November, 1988, issue 27(11)). Pp. 543-5.
-
-