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

PE in VWD

This is from Demetra “Toula” Castillo, Carolinas HealthCare. Can someone please explain to me how someone with a bleeding disorder can get a PE? She has type 2M VWD and takes Stimate for localized bleeds and gets monthly infusions of Humate-P. She also has endometriosis due to the VWD. Her last infusion was 3 weeks […]

Bleeding Disorders

Case Study: Bleeding Time

Here is a note from a new acquaintance, colleague Marjorie (Marj) Montanus: Hello, George. I am the new Hematology/Coag instructor in the Idaho State University Medical Laboratory Science program replacing Sonya Nehr-Kenat. We have been using an old case study that describes a “friable, soft clot after 24 hours of incubation at 37°C.” Could you […]

Bleeding Disorders

Hemophilia: Bispecific Antibody

Here is an editorial that appeared in the December, 2016 Journal of Thrombosis and Haemostasis describing the thinking that led to a coagulation factor VIII mimetic. This is a bispecific antibody that approximates factors IX and X to activate X while bypassing factor VIII. Designated ACE910, the mimetic enables normal clotting in hemophilia A when […]

Bleeding Disorders

Chromogenic VIII and IX Assays

What are the most accurate and reproducible assays for factors VIII and IX. For answers, I recommend an excellent educational article, Adcock D, Pruthi R, Tiefenbacher S, The value of the chromogenic activity assay in diagnosis and therapeutic monitoring of hemophilia. Med Lab Observer 2017, February, 8–14.

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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