Are Prophylactic Platelets Beneficial?

In a plenary session on Sunday, December 9, 2012, Dr. Simon Stanworth reported on a trial of 600 patients being treated for hematologic malignancies, chemotherapy, or stem cell transplants, Stanworth SJ, Estcourt L, Powter G, et al. The effect of a no-prophylactic versus prophylactic platelet transfusion strategy on bleeding in patients with hematological malignancies and severe thrombocytopenia (TOPPS […]

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Bleeding Disorders

Dec 18 2012

george

ELISA Vs. LIA VWF:Ag

From Jasmina Ahluwalia: Hi George, Is there any advantage of choosing an immunotubidimetric (latex immunoagglutination, LIA) assay over the enzyme-linked immunosorbent assay (ELISA) for von Willebrand factor antigen (VWF:Ag)? Hello, Jasmina, and thank you for waiting for this answer while we updated the Fritsma Factor site. The two methods have similar sensitivity, specificity, linearity, and coefficient […]

Bleeding Disorders

Managing the Bleeding Patient

I had the opportunity to present “Managing the Bleeding Patient” at the Northeast Laboratory Conference at the Holiday Inn By The Bay in Portland, Maine on Wednesday, October 17, 2012. Thanks to Ellen Libby, Program Chair, for inviting me,Dale Harrison, Ed Rojo and Roger Menk of Diagnostica Stago for hosting me, and to Crystal Azavedo for moderating the session. Please feel free to download my two-part handout below. […]

Bleeding Disorders

Quick Question Summary: VWF Activity

Here is a summary of our July, 2012 Quick Question: How do you assay for von Willebrand factor (VWF) activity? a. VWF ristocetin cofactor (VWF:RCo) by aggregometry: 21 (34%) b. Automated VWF ristocetin cofactor (VWFRCo): 21 (34%) c. VWF activity immunoassay (VWF:Act): 15 (25%) d. Collagen binding assay (CBA): 4 (7%) It seems the collagen […]

Bleeding Disorders

An Unexpected VWD by Lab Diagnosis

I learned about an interesting case at the University of Alabama at Birmingham(UAB) Hospital special coagulation lab today from specialty techs Patti Tichenor andLaura Taylor. A specimen arrived with an order for lupus anticoagulant profile and anti-cardiolipin antibody. The PTT was prolonged and corrected on initial mix. The UAB protocol recommends a two-hour incubation and repeat mixing study […]

Bleeding Disorders

3-MO with prolonged PT and PTT

From “Doctor Mukesh“: a 3 month-old with an old intracranial bleed and an sol has a markedly prolonged prothrombin time (PT) and partial thromboplastin time (PTT) and is bleeding from IV sites but looks pretty alright. What are the possibilities? Hello, and thank you for your question. The PT and PTT reference intervals at three […]

Bleeding Disorders

Combined Factor V and VIII Deficiency

The July issue of Clinical Chemistry presented a well-written case of combined factor V and VIII deficiency: Khani F, Roshal M. A 24-year-old man with previously diagnosed hemophilia. Clin Chem 2012;58:1086–90. Drs. EM Van Cott and JN Huang added commentaries. I noted the recommendation for plasma to replace factor V and posed this question: Dr. Khani, thank you […]

Bleeding Disorders

Monitoring Factors after Plasma Administration

From “japgi.” Hi! I’d like to get some information (if possible a reference) on this clinical situation. If a patient with an uncharacterized bleeding disorder has been transfused plasma or cryoprecipitate in an emergency setting, how soon afterwards can one do a coagulation screen to avoid the results from getting compromised by the transfused factors? […]

Bleeding Disorders

Bethesda Titer Protocol

Hello George! Our laboratory would like to start offering the factor inhibitor assay (Bethesda titer). We currently do special coagulation tests for several hospitals and clinics. I was wondering if there is a procedure you are willing to share. Sincerely, Maria E. Martinez, BS MT (ASCP), Senior Medical Technologist–Coagulation, Orlando Regional Medical Center. Hello, Maria, and […]

Bleeding Disorders

New Quick Question: VWF Activity Assays

There’s a definitive article in the June, 2012 JTH that describes the three methods currently available to assay von Willebrand factor activity: ristocetin cofactor (VWF:RCo), collagen binding (VWF:CB), and a monoclonal antibody-based immunoassay (VWF:Act). See Favaloro EJ, Bonar R, Chapman K, Meiring M, Funk (Adcock) D. Differential sensitivity of von Willebrand factor (VWF) ‘activity’ assays to large […]

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Bleeding Disorders

Bleeding Disorders

Are Prophylactic Platelets Beneficial?

ELISA Vs. LIA VWF:Ag

Managing the Bleeding Patient

Quick Question Summary: VWF Activity

An Unexpected VWD by Lab Diagnosis

3-MO with prolonged PT and PTT

Combined Factor V and VIII Deficiency

Monitoring Factors after Plasma Administration

Bethesda Titer Protocol

New Quick Question: VWF Activity Assays

George Fritsma MS MLS

Cheat Sheets from George

Questions or Comments?

Quick Question