Covid-Coag Conversation 9-15-20

You are invited to our Tuesday, September 15, 2020 webinar, Covid-Associated Coagulopathy: A Conversation about the Controversies and Confusion featuring pathology expert Andrew J. Goodwin, MD, University of Vermont Medical Center Laboratory Director. Click https://conta.cc/3aMDoNp for the eblast or bit.ly/COVID-Coag to go directly to the registration page. Covid-Coag is a PACE-accredited one-hour presentation, 5–6 PM […]

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Arterial Thrombosis

Aug 15 2020

george

PPP

George received a comment about platelet-poor plasma [PPP] from friend and colleague, Heather DeVries, Indiana University Health. Here is a paragraph from Fritsma GA. Laboratory evaluation of hemostasis, Chapter 41 in Keohane EM, Otto CN, Walenga JM. Rodak’s Hematology: Clinical Principles and Applications, 6th Edition, Elsevier, 2020. ISBN 978-0-323-53045-3: Platelet-Poor Plasma for Clot-Based Testing “Clot-based […]

Specimen Management

Mixing Studies

A note from colleague Kathy Robinson that deserves a thorough discussion… “I am updating our mixing study procedure and have some questions…” 1. What is the lower limit at which it is useless to perform studies for both PT & PTT [APTT]? There is no firm agreement about the limit. Some perform mixes whenever the […]

Bleeding Disorders

Markedly Elevated D-dimer in an Infant

A 4 month old girl was being prepped for surgery for a neural tube defect. All lab results were normal except her D-dimer result, which was greater than 20,000 ng/mL FEUs. The girl was in apparent good health, but the surgeon postponed surgery. The test was repeated after three days and the new D-dimer result […]

Fibrinolysis

WFH Guidelines: Third Edition

On August 4, 2020 the World Federation of Hemophilia announced the publication of the WFH Guidelines for the Management of Hemophilia, 3rd edition, 2020 [click for the publication]. The guidelines were developed by a team of experts from around the world and have been updated to reflect important developments in the management of hemophilia since […]

Bleeding Disorders

Case: Consistent D-dimer Elevation

A 35-YO woman experiences fatigue. The attached table [click] illustrates typical laboratory findings consistent over 18 months: reduced MCV, MCH, and MCHC, and mildly elevated ESR, CRP, and D-dimer. She reports that she has sickle-thalassemia, which accounts for her slightly decreased RBC indices. Please refer to our August Quick Question on the right, and choose […]

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Quick Question Archive

Jul 31 2020

george

July, 2020 Quick Question on Covid Coag Results

Our July, 2020 Quick Question, “What assay does your lab use to monitor Covid-19 severity?” attracted 64 responses that were nearly unanimous. Answers: Fibrin degradation products: 3 [5%] D-dimer: 53 [83%] PT and PTT: 3 [5%] Platelet count: 1 [2%] Other: 4 [6%] Several publications, especially from China, record the parallel use of FDPs and […]

Fibrinolysis

ISTH Guidelines for TTP

Here are the July, 2020 ISTH diagnostic guidelines for thrombotic thrombocytopenic purpura as reported at the recent digital congress: Zheng XL, Vesely SK, Cataland SR, et al. Guidelines for the diagnosis of thrombotic thrombocytopenic purpura. J Thromb Haemost 2020;pre-pub, doi: 10.1111/JTH.15006

Thrombophilia

Covid Labs Table

Here is an updated table of hemostasis, hematology and clinical chemistry assays plus inflammatory makers used to monitor Covid infection progression. Also attached is an article detailing the the diagnostic assays; RT-PCR and serological assays: Smithgall MC, Dowlatshahi M, Spitalnik SL, Hod EA, Rai AJ. Types of assays for SARS-CoV-2 testing: a review Laboratory Medicine […]

Thrombophilia

What is Osocimab?

The first phase 2 antithrombotic efficacy and safety results for the novel anti-activated coagulation factor XI [anti-XIa] monoclonal antibody are reported in Weitz JI, Bauersachs R, Becker B, et al. Effect of osocimab in preventing venous thromboembolism among patients undergoing knee arthroplasty; The FOXTROT randomized clinical trial JAMA. 2020;323:130–9. doi:10.1001/jama.2019.20687. This is an exciting new approach […]

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Anticoagulant Therapy

All Posts

Covid-Coag Conversation 9-15-20

PPP

Mixing Studies

Markedly Elevated D-dimer in an Infant

WFH Guidelines: Third Edition

Case: Consistent D-dimer Elevation

July, 2020 Quick Question on Covid Coag Results

ISTH Guidelines for TTP

Covid Labs Table

What is Osocimab?

George Fritsma MS MLS

Cheat Sheets from George

Questions or Comments?

Quick Question