Bleeding Disorders

Monitoring Extended Half-life Factors

From Allen Quigley, Hematology/Coagulation Technical Specialist, Children’s Hospitals and Clinics of Minnesota. George, what is the best way to measure factor VIII and IX levels on patients that are being infused with different products? We perform one stage clotting assays using Actin FSL, which is an ellagic acid activator, and other labs may use reagent […]

Bleeding Disorders

RiaSTAP

Although the FDA approved CSL-Behring’s RiaSTAP, human plasma-derived fibrinogen concentrate in 2009, it seems most facilities continue to use cryoprecipitate to treat hypofibinogenemia, dysfibrinogenemia, and afibrinogenemia. Has your institution switched to RiaSTAP? Why, or why not? For the answer, see this reference provided by George’s UAB colleague, pathologist Lawrence A. Williams III: “After adjusting for […]

Bleeding Disorders

VWF Reference Interval

From Sharon Johnson, Sysmex America: Hi George: I was recently asked if guidelines or clinical recommendations had changed for VWF normal ranges based on blood group. In CLSI Guideline H-51A. 2002, it suggests laboratories establish their own reference ranges for VWF for “O” and “Non-O” blood groups, as patients with group “O” typically have much […]

Bleeding Disorders

Nijmegen Bethesda Assay

Dr. Ali Sadeghi-Khomami, Precision BioLogic Inc., provided these in-depth technical questions about the Nijmegen Bethesda Assay (NBA), which we use to quantitate specific factor inhibitors such as anti-factor VIII or anti-factor IX. George forwarded his questions to Connie Miller and Amanda Payne, US Centers for Disease Control and Prevention (CDC) who have been working on […]

Bleeding Disorders

Hemorrhage Management

George recommends the June, 2017 CAP Today article, Life-threatening Bleeding–What’s the Right Call? The article features Drs. Theresa Nester and Tom DeLoughery and provides practical advice for massive blood loss and transfusion protocols.

Bleeding Disorders

World Federation of Hemophilia

Elaine Benoit of Precision BioLogic introduces the World Federation of Hemophilia, currently developing and administering their World Bleeding Disorders Registry, The WFH site is rich with authoritative bleeding disorder information and references.

Bleeding Disorders

TXA in Post-partum Hemorrhage

George has attached a Lancet open access article on the effectiveness of tranexamic acid in controlling post-partum hehorrhage. Thanks to John Gerlach, PhD, Director, Biomedical Laboratory Diagnostics Program, Michigan State University for this timely information. Click here for the Lancet Article and for an editorial featuring the article’s outcomes.

Bleeding Disorders

Case: VWD Type 2?

From Dr. Jasmina in India: Hello George. I need some thoughts on a case with bleeding. An 8 month old female child was referred for workup for a bleeding disorder. The mother noticed ecchymotic patches over the arms, legs and back over the previous two weeks and a single episode of epistaxis. The platelet count […]

Bleeding Disorders

Measuring the New Factor Concentrates

George recommends the April CAP Today article, Hemophilia Management, Tips on Monitoring Modified Replacement Therapies. The article, featuring Stefan Tiefenbacher, PhD, of Colorado Coagulation, and Rajiv K. Pruthi, MBBS, of Mayo Labs, describes the newly approved extended half-life coagulation factor VIII and IX concentrates. Hemophilic boys are delighted to reduce the frequency of infusions, however the […]

Bleeding Disorders

Schistocytes in Urine Sediment?

This question was posed by a participant in the Rutgers University graduate course, CLSC 5123, Advanced Hematology. Rutgers’ Clinical Laboratory Science program, directed by Elaine Keohane, PhD, offers an online masters degree program with advanced coursework that atrracts laboratory supervisors and managers. Here is the question. My laboratory has had some requests recently to “identify […]

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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