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Bleeding Diathesis Discussion Part 2

Additional responses to Dr. Ari Elman’s undiagnosed bleeding diathesis case. Recalling that in Dr. Elman’s case review, the patient denies using supplements, these comments nevertheless point to a diet-based acquired platelet disorder and suggest that the patient may have under-reported her use of supplements, a common occurence. From Ali Sadeghi-Khomami, PhD, Scientific Director, Precision BioLogic: […]

Bleeding Disorders

Bleeding Diathesis Discussion Part 1

We received several responses to Dr. Ari Elman’s 12/20/17 Undiagnosed Bleeding Diathesis post. This post begins a summary of possibilities. From George Fritsma, moderator, given that the patient’s platelets fail to secrete in response to ADP, epinephrine, and arachidonic acid, could this be an acquired platelet activation pathway enzyme deficiency? Could she have developed an […]

Bleeding Disorders

Case: Undiagnosed Bleeding Diathesis

From Dr. Ari Elman, Hematology and Medical Oncology, Sandra & Malcolm Berman Cancer Institute, Greater Baltimore Medical Center: I asked you a question last month and was quite impressed with the thorough response and the team of experts you had weigh in. I have an extremely difficult case with a young woman, just 22 years old, who […]

Bleeding Disorders

Prothrombin Time Mixing Studies

A colleague recently contacted George about prothrombin time mixing studies. Apparently, the College of American Pathologists provided a PT mixing study challenge in a recent survey. George discussed PT mixing studies with Fritsma Factor advisers Larry Brace, PhD and Dave McGlasson who helped list reasons for not doing them: Reasons for not performing a PT […]

Diagnostic Management Teams

George just finished reading Michael Laposata’s Diagnostic Management Teams article in the November CAP Today. I recommend the article, it is a quick, easy read and gets to the heart of the need for DMTs that exploit the knowledge of laboratory scientists, radiologists, specialists, and clinicians. Dr. Laposata also hosts a DMT conference, February 6 […]

December Quick Question: Tube Labeling

Dennis Ernst, Center for Phlebotomy Education; Dave McGlasson; and George are preparing an opinion piece for Annals of Blood that describes blood specimen labeling standards. The European Federation of Clinical Chemistry and Laboratory Medicine Working Group on Preanalytical Phase specifies that blood specimens must be labeled prior to collection, whereas the Clinical Laboratory and Standards […]

Specimen Management

November Quick Question: Thrombophilia

Here are the results of our November, 2017 Quick Question, answered by 60 respondents: Question: When should you perform an antithrombin, protein C, and protein S profile? a. Soon after starting anticoagulant therapy: chosen by 0 respondents, 0% b. Just after a thrombotic event but before starting anticoagulant: chosen by 10 respondents, 17% c. Seven […]

Quick Question Archive

Automated Bethesda Titre

From Jasmina, Department of Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh India Hello George. This is regarding running the factor VIII assay for the Bethesda assay on automated analysers. When performing the Bethesda assay on the coagulation analysers like the ACL TOP (IL), we make the doubling dilutions of sample and add them […]

Bleeding Disorders

THSNA Call For Abstracts: 11-17-17

Last minute THSNA call for abstracts (tomorrow is the deadline), see their web site for details. The meeting is March 8–10 in San Diego.

Cold Platelet Storage

George found a provocative ASH platfom presentation abstract by A. Cap, “Targeting Hemorrhage: Alternative Storage of Platelets for Hemostatic Transfusion.” describing alternatives to current platelet concentrate storage guidelines. Saturday, December 9, 9:30 or 4.

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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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