Fibrinolysis

More on Unexplained Elevated D-dimer

Here is an update to Tony Tang’s D-dimer post from Fritsma Factor technical advisor Donna Castellone, QA Manager, Specialty Testing and Supervisor, Special Coagulation and Hematology at New York Presbyterian-Columbia. Donna writes, my input on TEG is limited, however I agree with what you said. Tony can also look at factor V and protein C to […]

Unexplained Elevated D-dimer

From Tony Tang: Dear George, recently we met a 1 year old child with serious hepatitis, the results of coagulation tests were as follows: PT: 26s, APTT: 56s, FIB: 1.07 g/L, TT: 23s, D-dimer: greater than 80 ug/mL FEU, FDP: greater than 360 ug/mL, AT-III: 54%, factor VIII: 212%, PLT count: 102 X 109/L (and […]

More on Age-Adjusted D-dimer Limits

I’d like to draw your attention to the numerous and insightful responses to Sylvia Stacy‘s question about applying age-adjusted D-dimer limits to venous thromboembolic disease diagnosis, especially Dr. Giuseppe Lippi’s entry with a link to his brief questionnaire, which he intends to keep open through February, 2015. Let’s give Dr. Lippi as many responses as possible.

Age-adjusted D-dimer Limit?

Hi George, I am wondering if anyone is using the age-related D-dimer cutoff for the emergency room based on the ADJUST-PE study? We use Innovance D-dimer reagents from Siemens on the BCS XP analyzer. Our ER physicians are very impatient for us to allow them to use this age-adjusted cut-off, but we have reservations due […]

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 […]

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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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