• Giancarlo Castaman, Sofia H Giacomelli, Chiara Biasoli, Laura Contino, and Paolo Radossi.
• Department of Oncology, Center for Bleeding Disorders and Coagulation, Careggi University Hospital, Florence, Italy.
• Eur. J. Haematol. 2019 Oct 1; 103 (4): 379-384.

ObjectivesInherited dysfibrinogenemia is a rare disorder, for which clinical studies related to the risk of bleeding or thrombosis and the type of causative mutation are scanty.Materials And MethodsWe analyzed the laboratory, clinical, and genotypic features of 50 patients with inherited dysfibrinogenemia belonging to 19 unrelated families.ResultsIn all the index cases, fibrinogen activity by Clauss method was below the normal range, while it was observed in 57.9% only by PT-derived method. In three families, hypodysfibrinogenemia was evident, associated with three novel mutations (Ter492Gln in FGB, Cys365Asp, and Leu370Phe in FGG). Three additional novel mutations were also identified (Arg114Lys in FGA, Ile131Thr and Trp234Arg in FGG). Bleeding symptoms assessed by ISTH-BAT scored at least 1 in 30% of patients and, significant bleeding symptoms were mainly present in female patients, especially associated with pregnancy. Two patients with FGB Arg44Cys suffered from venous thromboembolism, and two with FGA Arg35His had ischemic stroke at older age.ConclusionsThis study confirms the heterogeneity of clinical features in inherited dysfibrinogenemia, due to the wide spectrum of the causative mutations. Larger multicenter studies are needed to assess the definitive correlation of some mutations with bleeding or thrombosis.© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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