Bleeding Disorders

October 2019 QQ: Distinguish Liver Disease from VK Deficiency

Our October, 2019 is a poll designed to learn how your coagulation laboratory distinguishes hemorrhage caused by liver disease from hemorrhage caused by vitamin K deficiency. If you have an alternative not provided among the possible answers, please post your comment here.

Bleeding Disorders

September, 2019 QQ Response: Poor Wound Healing

Here is our September, 2019 Quick Question with responses from 100 participants. A 25-YO experienced chronic soft tissue bleeding and poor wound healing. His PT, PTT, and PLT count were normal. What follow-up assay is indicated? a. Platelet aggregometry 24 (24%) b. Factor VIII and IX assay 12 (12%) c. Factor XIII assay 37 (37%) […]

Bleeding Disorders

New Statistics on Hemophilia Prevalence

Thanks to Elaine Benoit, Precision BioLogic Inc., for the heads-up on this newly released hemophilia study revealing a higher prevalence than previously reported. Also, the life expectancy disadvantage data are striking. Researchers from McMaster University, North Carolina State University, Aix-Marseille University, and the University of Sheffield joined efforts to respond to a call to action […]

Bleeding Disorders

A Link Between aHUS and TTP

Click or tap September 3, 2019 UAB News for an article featuring X. Long Zheng, MD, PhD, Robert B. Adams Professor of Pathology and Division Director of Laboratory Medicine at the University of Alabama at Birmingham. Using knockout mice, Dr. Zheng’s group has established a link between complement control protein H deficiency, a mechanism that […]

Bleeding Disorders

September, 2019 Quick Question

Please go to our September, 2019 Quick Question on the right, “A 25-YO experienced chronic soft tissue bleeding and poor wound healing. His PT, PTT, and PLT count were normal. What follow-up assay is indicated?” If you don’t see an answer you like, please add a comment. Thank you.

Bleeding Disorders

Factor Inhibitors: The SIPPET Study

Here is a short free full text article describing the outcomes of the 2010–17 Survey of Inhibitors in Plasma-Product Exposed Toddlers (SIPPET) study. The study compares inhibitor incidence arising from rFVIII (recombinant) concentrate compared to pdFVIII (plasma-derived) concentrate. Further, in an important addition to hemophilia therapy protocol, SIPPET also compares inhibitor incidence in hemophilic F8 […]

Bleeding Disorders

July, 2019 QQ: Managing Trauma

Our July, 2019 Quick Question was directed to trauma centers, and attracted 22 responses. The question was… How does your institution manage trauma-induced coagulopathy? Crystalloid plasma expanders 3 (14%) pRBCs 2 (9%) 1:1:1 components 12 (54%) Whole blood 2 (9%) Tranexamic acid 3 (14%) Thank you for your answers. Arising from military experience, a handful […]

Bleeding Disorders

Therapeutic Reptilase

Ning Tang writes, Dear George, In China, a categary of hemostatic agents from snake venom named “Haemocoagulase” are widely used, basically they are the generic drugs of Reptilase®, which is produced by a Swiss company. We find that intravenous injection of this drug can cause severe hyperfibrinolysis and hypofibrinogenemia. It seems that Reptilase has been […]

Bleeding Disorders

Vitamin K Kinetics

George received a series of questions about vitamin K kinetics from colleague and friend Catherine N. Otto, MLS, PhD, Rutgers University. Dr. Otto is assisting a Nutrition Science colleague. It seems that vitamin K deficiency (as defined by PT/INR) does not show up until there is serious depletion in the amounts of these activated proteins. Why? […]

Anticoagulant Therapy

Case: VWD? Please Answer

A 16-year-old girl experiences chronic menorrhagia. Her PT is 12.2 s, PTT 37.1 s (H), factor VIII activity 51% (L), VWFag 54%, VWFactivity 45% (L), VWFRCo 43% (L), VWF multimers: normal distribution. CBC results are normal except HGB is 11.8 g/dL (L). What is her presumptive diagnosis, what follow-up testing, if any, is necessary, and […]

Bleeding Disorders

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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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