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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (3): 412-414    DOI: 10.31083/j.ceog.2020.03.5244
Case Report Previous articles | Next articles
A 26-year-old pregnant woman with mild gingival bleeding
J.Z. Zeng1, Y. Dong1, H.Y. Zhu1, X. Xie1, J.R. Liu1, L. Li2, Y.H. Zhai1, Z. Cao1, *()
1Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, P.R. China
2Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, P.R. China
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Abstract  

Congenital dysfibrinogenemia is a genetic coagulopathy that leads to compromised fibrinogen function. This case report describes a 26-year-old pregnant woman at the 38th week of gestation who presented with mild gingival bleeding and constant bruising on her joints. As part of her laboratory workup, fibrinogen was found to be significantly decreased and thrombin time was prolonged. Using whole exome DNA sequence analysis, a heterozygous mutation was identified in the fibrinogen α (FGA) (c.104G > A; p.R35H) gene. This mutation has been reported previously in congenital dysfibrinogenemia (CD) patients who are usually asymptomatic and lack any obvious thrombotic complications. However, both post-partum disseminated intravascular coagulation and mild bleeding have been observed in this type of mutant. The patient in our case received fibrinogen concentrate as replacement therapy during her cesarean section to prevent severe bleeding. Neither major bleeding nor a thrombotic event was observed throughout her surgery.

Key words:  Dysfibrinogenemia      Heterozygous mutation      Fibrinogen      Bleeding      Thrombosis     
Submitted:  16 April 2019      Accepted:  26 June 2019      Published:  15 June 2020     
Fund: 
FCYYQN-201607/Specialized Youth Foundation Project of Beijing Obstetrics and Gynecology Hospital, Capital Medical University
*Corresponding Author(s):  ZHENG CAO     E-mail:  zhengcao2011@hotmail.com

Cite this article: 

J.Z. Zeng, Y. Dong, H.Y. Zhu, X. Xie, J.R. Liu, L. Li, Y.H. Zhai, Z. Cao. A 26-year-old pregnant woman with mild gingival bleeding. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(3): 412-414.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.03.5244     OR     https://ceog.imrpress.com/EN/Y2020/V47/I3/412

Table 1  — Coagulation testing results
Test Patient's Result Reference Interval
FIB (Clauss) 0.70 1.80-4.00 g/L
FIB (Antigen) 4.6 2-4 g/L
PT 11.9 10.0-14.0 sec
TT 28.4 14.0-21.0 sec
APTT 25.4 22.80-35.00 sec
D-dimer 1.11 0.00-0.55 mg/L
Figure 1.  — DNA sequencing analysis: single nucleotide substitution on FGA exon 2. FGA exon 2 c.104G >A mutation led to Arg35His in amino acid substitution in nascent chain. Genetic testing suggested Arg16His mutation in mature Aα chain.

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