Chromogenix factor X assay

In 1997, Moll and Ortel published a study concluding “lupus anticoagulants (LAs) can influence prothrombin times (PTs) and lead to INRs that do not accurately reflect the true level of [oral anticoagulant therapy (OAT)]. Use of the INR to standardize PTs is invalid for some patients with lupus anticoagulants. To prevent supratherapeutic or subtherapeutic anticoagulation, […]

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Mar 10 2008

george

Visible Hemolysis

This is a question from my colleague and neighbor, Vicki Cardone. Do you feel slight hemolysis would compromise PT/PTT results? If so would you recollect or add a comment to let physician know the results may be falsely decreased. We are a Children’s Hospital and do not want to recollect unnecessarily. Thanks. Vicki Cardone, Children’s […]

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Reporting PT in Seconds and INR

There is an interesting article in the February issue of the Journal of Thrombosis and Haemostasis, Trippodi A, Chantarangkul V, Mannucci PM. The international normalized ratio to prioritize patients for liver transplantation: problems and possible solutions. J Thrombos haemostas 2008;6:243-8. I’m led to provide a clinical discussion of reporting conventions for the prothrombin time test […]

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Confusing Test Names Involving II, V, and X

We also try to confuse clinicians with our use of II, V, and X as Sue Osier mentioned. If you see an order for factor X, chances are the clinician wanted an anti-Xa heparin assay, although some institutions are using a chromogenic factor X as a PT substitute when the PT is not reliable. Likewise, an isolated order for factor V or factor […]

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Confusing Test Names Involving the Letter C

Anyone who works in a special coagulation laboratory has received an isolated order for protein C. A protein C activity assay alone makes little sense, and we know the order was probably erroneous. This is our fault for using confusing test names. Is it protein C, activated protein C resistance (APCR), or C-reactive protein? These […]

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How to Discontinue FDPs

At our institution we currently offer a quantitative D-dimer using the Sysmex CA-1500, and a fibrin degredation products assay (FDP, Remel Thrombo-Wellco Test). What can I say to our physicians to convince them to allow us to stop offering the FDP, and to rely on the D-dimer (along with the platelet count, PT, PTT and […]

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Von Willebrand Disease Tests

We are testing two ELISA kits, one with a monoclonal antibody on the platelet directed at the portion of the VWF that binds the platelet and the other is the collagen binding assay. We often have trouble with our ristocetin cofactor assay. Do you, or does anybody, have any preferences or personal experience with either […]

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Focus: Information Literacy

One of my “side” jobs is continuing education editor for Clinical Laboratory Science, the journal of the American Society for Clinical Laboratory Science. This has nothing to do with hemostasis, but I wanted to draw your attention to a well-written and exceptionally practical focus series, “Information Literacy,” appearing in the Winter, 2008 issue. The series […]

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How Do Factor VIII or IX Deficiency Cause Bleeding?

Hi George, Thank you, thank you, thank You for your educational materials. I have been a tech for 20-some years but this is my first year in special coag and your lectures have helped me tremendously. From the cell-based coagulation lectures, I am having trouble understanding why the TF/VIIa route does not compensate for […]

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Qualitative and Quantitative D-dimer

On Thursday, February 21, 2008, Colleen Marinucci from Elmendorf AFB wrote: We perform the SimpliRED® qualitative d-dimer assay (AGEN Biomedical Ltd, Brisbane, Queensland, Australia, distributed in the USA by American Diagnostica, Inc, Stamford, CT). Our internal med docs wondered why a patient with a small pulmonary embolism tested negative. This patient has, among other problems; […]

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All Posts

Chromogenix factor X assay

Visible Hemolysis

Reporting PT in Seconds and INR

Confusing Test Names Involving II, V, and X

Confusing Test Names Involving the Letter C

How to Discontinue FDPs

Von Willebrand Disease Tests

Focus: Information Literacy

How Do Factor VIII or IX Deficiency Cause Bleeding?

Qualitative and Quantitative D-dimer

George Fritsma MS MLS

Cheat Sheets from George

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