Differential Diagnosis for Fibrinogen Level of 499 and/or Easy Bruising with Heavy Alcohol Use
- Single Most Likely Diagnosis
- Liver disease (e.g., cirrhosis): Heavy alcohol use is a common cause of liver disease, which can lead to decreased fibrinogen production and easy bruising due to impaired coagulation factor synthesis.
- Other Likely Diagnoses
- Vitamin K deficiency: Heavy alcohol use can lead to poor nutrition and malabsorption, resulting in vitamin K deficiency, which is essential for coagulation factor production.
- Disseminated intravascular coagulation (DIC): Although less common, heavy alcohol use can contribute to conditions that increase the risk of DIC, such as sepsis or trauma, leading to consumption of coagulation factors, including fibrinogen.
- Chronic liver disease with associated hypersplenism: This can lead to sequestration of platelets, contributing to easy bruising.
- Do Not Miss Diagnoses
- Hemophilia A or B: Although less common, these conditions can present with easy bruising, and a low fibrinogen level may be seen in some cases due to bleeding-induced consumption of coagulation factors.
- Acute liver failure: This is a life-threatening condition that requires prompt recognition and treatment; easy bruising and low fibrinogen levels can be presenting features.
- Malignancy (e.g., liver or pancreatic cancer): Certain cancers can cause coagulopathy, including decreased fibrinogen levels, and easy bruising.
- Rare Diagnoses
- Congenital afibrinogenemia: A rare genetic disorder characterized by the absence of fibrinogen, leading to easy bruising and bleeding.
- Lymphoma or leukemia: Certain hematologic malignancies can cause coagulopathy, including decreased fibrinogen levels, although this is less common.
- Amyloidosis: A rare condition that can cause coagulopathy, including decreased fibrinogen levels, due to deposition of amyloid proteins in organs, including the liver.