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Autoanti-FVIII and the Bethesda Titer

From Kim Kinney. (Clarian gets the most interesting cases.) Hi George. We have a patient with an acquired factor VIII (FVIII) inhibitor. He started out having <1% VIII, but he is now up to 33%. He has had a Bethesda titer all along, but it is starting to go down. One thing I noticed is […]

UAB Hemophilia Therapy Lecture

On Thursday, May 21, 2009 at the University of Alabama at Birmingham Department of Pathology I provided a lecture on the history of hemophilia therapy entitled “Hemophilia Therapy, Rasputin to Recombinants.” Here is the lecture as a 6-per page PDF for the lecture participants or any Fritsma Factor members. Geo.

Platelet Aggregometry Lecture

About four times a year Path residents and Heme-Path fellows rotate through Special Coagulation at UAB and I get the opportunity to provide a few lectures. Thursday I lectured on platelet aggregometry, but I didn’t prepare quite enough handouts. Here is the handout as a 6-per page PDF for those who need it, and of course, […]

Platelet Aggregometry and Aspirin

This week’s question was, “How long do you require patients or controls to go without aspirin before platelet aggregometry?” The answers are below… a. 48 hours: 5 (14%) b. 7 days: 11 (32%) c. 10 days: 14 (40%) d. 14 days: 5 (14%) This is a wide spread of answers, reflecting the lack of agreement […]

Thromboelastograph

Kim Kinney at Clarian has this question about the Thromboelastograph: A pathologist who trained here asked me about the thromboelastograph (TEG). Do you have any information on who uses this device, how difficult it is to perform, and QC? We have had several docs asking us to get this device but we have not gone […]

Critical Values for PTT

Here is a message sent on Monday, May 11, 2009 from Emily Oakley: With minimal staffing, I am trying to cut down on the number of phone calls placed to unit staff. In your lab, do you have two PTT critical values, one for heparinized patients, and one for non-heparin patients such as pre-admits or […]

Handout from CLCC Presentation

We’ve not quite completed our switch to WordPress, and I have several messages and topics pending, so I’ve decided to post to our old shell for now. I’m currently in Denver attending the Wyoming-Colorado Clinical Laboratory Collaborative Conference(CLCC). CLCC has a well-attended annual program sponsored by ASCLS-Colorado, ASCLS-Wyoming, the Clinical Laboratory Managers’ Association, and the Colorado Association […]

More on the INR

I routinely monitor Pat Letendre’s bulletin board service, Medlab-L, and lately there has been a thread discussing whether to report the INR alone or with the prothrombin time. Here is a comment from Dave McGlasson that I found to be helpful. Many have questions about reporting out either the PT with the INR or just […]

Fitzgerald and Fletcher Factor Deficiencies

Another brain teaser from Kim Kinney at Clarian in Indianapolis: Hi George, I am working on a case study for American Society for Clinical Laboratory Science (ASCLS). We had a patient who came in for a right hip replacement and ended up being < 1% high molecular weight kininogen (HMWK, Fitzgerald factor) and 58% prekallikrein […]

Quick Question: PT Delta Check

The PT delta-check question was… Please select the 24-hour PT delta-check range closest to the one you use. The answers… a. 0.5: 8 (42%) b. 0.1: 5 (26%) c. 1.5: 2 (11%) d. 2.0: 4 (21%) In interpreting these results, a number of people reported earlier they used no delta check on the PT result. […]

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George Fritsma is a medical laboratory scientist, educator, and author. George is a member of the International Society on Thrombosis and Hemostasis, the International Society for Laboratory Hematology, and the American Society for Clinical Laboratory Science.

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