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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Fibrinolysis

Oct 12 2013

george

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 […]

Fibrinolysis

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 […]

Fibrinolysis

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. […]

Fibrinolysis

Quest Presentation

Thank you to all who attended George’s presentation, Case Studies in Antithrombotic Therapy, made on Friday, October 12 at the Quest Diagnostics Case-oriented Symposium on Bleeding and Thrombosis in Crystal City, VA, near Washington, DC. As promised, here is my presentation in 6-per-page handout format. Please click the link and feel free to download the file. […]

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Anticoagulant Therapy

Oct 3 2012

george

D-dimer Versus FDP

From FD Patel, MD: I had a patient here who was tested for both FDP and D-dimer. Her D-dimer was mildly elevated at 0.79 but her fibrin degradation products (FDP) assay result was undetectable. Since the D-dimer is a type of fibrin split product, how can you explain this discrepancy? I’m thinking it has something to […]

Fibrinolysis

TPA for Pleural Effusion

A colleague contact me on August 24 about a relative who is an inpatient and is experiencing a pleural effusion subsequent to a MRSA infection. The MRSA has been treated and is resolved, but the effusion is mucinous and drains slowly. The surgeon was planning to use recombinant tissue plasminogen activator (TPA, Alteplase) to liquify […]

Fibrinolysis

Specimen Management in Fibrinolysis

I had the opportunity to become reacquainted with Jennifer Jacobsen, MLS (ASCP),Allina Health Laboratories, Minneapolis, while attending the Mayo Laboratories Coagulation Testing Quality conference in Rochester, Minnesota August 7–10. Jennifer has this question about specimen management on patients being treated with tissue plasminogen activator (TPA, Activase®, Alteplase®): George, both the prescribing information for Alteplase and Stago’s fibrinogen reagent package […]

Fibrinolysis

D-dimer: Double-spin?

Hi George. Why is it not important to double-spin D-dimer specimens for platelet poor plasma (PPP) when there’s a delay in testing? Is this because D-dimers are not affected by labile factors as other coag testing? Looking forward to your answer. Teresa Lovejoy, MT (ASCP) Senior Medical Technologist, Hematology Children’s of Alabama. Birmingham, AL Hi, […]

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Fibrinolysis

Fibrinolysis

Fibrinogen Assay for Pleural Effusion?

Prolonged PT, TT, and PTT

D-dimer Discrepancy

Adjust D-D for HCT?

D-dimer of 0.0 ng/mL?

Quest Presentation

D-dimer Versus FDP

TPA for Pleural Effusion

Specimen Management in Fibrinolysis

D-dimer: Double-spin?

George Fritsma MS MLS

Cheat Sheets from George

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