Fibrinolysis

Wide D-dimer Fluctuations

From Tony Tang, Clinical Laboratory of Tongji Hospital, Wuhan, China: Hello George, recently we’ve met two or three cases from paediatrics with unexplained massively elevated D-dimer. In these cases, PT and PTT were normal, levels of fibrinogen were decreased (about 1.0-1.5g/L), different D-dimer reagents (STAGO AND IL) got consistent results, levels of rheumatoid factors were normal, clot and […]

Back to the ELT

In follow-up to Cassandra McGeachy’s August 7 question on the euglobulin lysis time (ELT), I’ve found two references for upgraded ELT methods that may be helpful.They are: Cellai AP. Lami D, Magi A, et al. Assessment of fibrinolytic activity by measuring the lysis time of a tissue factor-induced clot: a feasibility evaluation. Clin Appl Thromb Hemost 2010;16:337–44. […]

Euglobulin Lysis Time

From friend and colleague Cassandra McGeachy, Louisiana Coagulation Laboratory, Hi George, I am looking for procedures available for performing the euglobulin lysis time (ELT). I am looking to update my present method if there are any options available. Hello, Cassy, and thank you for your question. At first I was going to suggest you just discontinue the […]

Fibrinolytic to Treat Clotted Fluids

George, This is not really a coag question but relates to an issue we see intermittently in our clinical lab. It is the problem of receiving clotted body fluid specimens with the request of a cell count to be performed. While educating the clinician to put the specimen in an anticoagulant tube is ideal to […]

D-dimer in Body Fluids

Here is a note from the American Society for Clinical Laboratory Science Consumer Web Forum: What is the normal value of D-dimer in pleural or peritoneal fluids. I know the normal range of D-dimer in the blood is less than 250 ng/mL D-Dimer Units but what about other body fluids? Thank you. I have found no reference to […]

Fibrinogen Assay for Pleural Effusion?

From Pam Owens, Centennial Medical Center, Nashville, TN. Recently a pediatric group approached us asking if we would do a fibrinogen level on pleural fluids before and during administration of tissue plasminogen activator (TPA, Alteplase) for resolution of the effusion. I found the previous reference to this treatment in a post from August 2012, but no mention of […]

Prolonged PT, TT, and PTT

From Ning Tang: Hi, George, I come from a clinical laboratory in China. We met a confusing case today and want to get your suggestion: A patient had a prolonged prothrombin time (PT, 20s), partial thromboplastin time (APTT, PTT, 52s) and thrombin time (TT, 127s). Fibrinogen activity is within reference interval (by both Clauss method and […]

Bleeding Disorders

D-dimer Discrepancy

From Suakimi Pouhila, Auckland District Health Board, New Zealand. We have a patient which showed high D-dimer results with Siemens’ Innovance D-dimer but normal Stago D-dimer results. Has anyone seen this before? Is this due to cross reaction with a heterophile antibody? Hello, Suakimi Pouhila, and thank you for your question. The various monoclonal antibodies that are […]

Adjust D-D for HCT?

From Michael Suter, MT (ASCP) SH Senior Clinical Scientist, Hematology, Peace Health Laboratories, Springfield, Oregon. George, I am curious about your thoughts on how to best address the effect of high hematocrits (HCTs) on the quantitative latex D-dimer assays such as the Stago D-Di test. With high HCT samples, there is a relative decrease in plasma causing […]

D-dimer of 0.0 ng/mL?

From Joanna Carroll, MT (ASCP), North Carolina State University College of Veterinary Medicine. We are running automated D-dimers and recently got a result of 0.00 ng/mL. Have you seen a value reported this low? Would it be better to report out the number as less than our lower limit of the reference range? Thanks for your help. […]

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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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