VWF:RCo Interference

From Jasmina Ahluwalia, MD: Hello George, We use the IL vWF Antigen (VWF:Ag) and vWF Ristocetin Cofactor (VWF:RCo) activity kits on the ACL TOP 500 analyser. Lately, I have noticed that in nearly 5% of the samples tested we have VWF:RCo activity levels that are much higher than the antigen levels. We have repeat tested […]

Comments (0)

Bleeding Disorders

Jan 11 2018

george

POC and Plasma-based PT/INRs

We’ve had a number of discussions comparing point of care PT/INR results with central laboratory plasma-based PT/INRs. The December, 2017 CAP Today featured this issue in their cover article, Hemostasis, Two Hot-button Testing Issues. The first half of the article reviewed the need for age-adjusted D-dimer reference intervals for ruling out DVT and PT, and […]

Comments (0)

Anticoagulant Therapy

Jan 11 2018

george

Age-adjusted D-dimer, 12/2017 CAP Today

The December CAP Today featured an article about age-adjusted D-dimer assay reference intervals.The article features interviews with Drs. Russell Higgins, Dorothy Adcock, Karen Moser, Oksana Volod, and Chris Lehman. See also our in-depth on this topic in response to a November 8, 2014 entry from Sylvia Stacy, Concord Hospital, NH. It appears from the CAP […]

Thrombophilia

Yet More on Reference Intervals

This is a follow-up comment from Bob Gosselin on Griselle Font-Bonet’s December 31 post about reference intervals. The original post drew many thoughtful and provocative comments from Dave McGlasson, and Drs. Ali Sadeghi-Khomami and Emmanuel Favaloro; consequently, it became so long that an add-on comment would make it unwieldly. Bob says these “last thoughts”… Lest […]

Bleeding Disorders

When to Label Tubes

Our December, 2017 Quick Question asked, “When is the correct time to label blood specimen tubes?” The question generated 124 votes, an exceptional total that illustrates the level of concern for this issue. The answers were: Prior to meeting the patient: 6 (5%) In the presence of the patient, before collecting the blood: 36 (29%) […]

Comments (0)

Quick Question Archive

Dec 31 2017

george

Reference Intervals

From Griselle Font-Bonet: We are having problems establishing the reference ranges for the intrinsic coagulation factors VIII, IX, and X. We are using normal plasmas from volunteers, but we are getting results above the upper limit of the manufacturer range (60-150%). Calibration and QC values are good. Does anyone have a recommendation?From George: Hello, and […]

Validation

Cynthia Johns

With regret, George announces that friend and colleague Cynthia (Cindy) S. Johns passed away this Christmas Eve after many years of treatment for cancer. Cindy was living in Lakeland, Florida, where plans for her memorial are currently in progress. Cindy was well-known throughout the hemostasis world for her technical and writing skills. She had worked […]

Events

Bleeding Diathesis Discussion Part 3: QPD

This discussion of Quebec Platelet Disorder (QPD) is in response to Dr. Ari Elman’s undiagnosed bleeding diathesis case and expands on the comment by Dr. Emmanual Favaloro. QPD is a functional disorder caused by autosomal dominant duplication of the PLAU gene located on chromosome 10. PLAU codes for platelet urokinase (urinary plasminogen activator, uPA), and […]

Bleeding Disorders

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 […]

Comments (0)

Bleeding Disorders

All Posts

VWF:RCo Interference

POC and Plasma-based PT/INRs

Age-adjusted D-dimer, 12/2017 CAP Today

Yet More on Reference Intervals

When to Label Tubes

Reference Intervals

Cynthia Johns

Bleeding Diathesis Discussion Part 3: QPD

Bleeding Diathesis Discussion Part 2

Bleeding Diathesis Discussion Part 1

George Fritsma MS MLS

Cheat Sheets from George

Questions or Comments?

Quick Question