Nov 1 2017

george

October 2017 QQ Responses

Our Quick Question for October, 2017 was a quiz question with one correct answer: you perform platelet aggregometry. Aggregation results are normal in response to all agonists except ristocetin. You rule out VWD. What diagnosis could it be? a.  Bernard-Soulier syndrome: 47 (61%) b. Glanzmann thrombasthenia: 18 (24%) c. Aspirin-like syndrome: 8 (10%) d. Storage […]

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Platelet Function Testing

Oct 13 2017

george

Point of Care Platelet Function Testing

Here is another note from Dr. James Quesenberry, St. Lukes Laboratory, Sioux City, Iowa regarding point-of-care platelet function testing using the Siemens PFA-100. His comments… This is a test that we don’t do often but is a pain in our sides. We have always required a path interpretation, usually the patient has multiple medical problems […]

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Platelet Function Testing

Feb 19 2017

george

Acquired Glanzmann

Dr. Sarode’s February 17 post mentioned acquired Glanzmann thrombasthenia (GT). I’ve attached a case study describing and defining this autoimmune bleeding disorder. By coincidence, Heather DeVries saw an acquired GT in the Indiana University Medical Center lab. Heather used her own platelets as a control to demonstrate how the patient’s antibody suppressed normal platelet aggregation. […]

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Bleeding Disorders

Feb 17 2017

george

Yet More: Whole Blood Aggregometry

From Ravinda (Ravi) Sarode, MD, Chief of Pathology, University of Texas Southwestern Medical Center, Dallas. Hey George, sorry for late response. I have used WBA since 1987! I have made comparisons between the two methods and every time found WBA more sensitive. One example I will quote is a patient with CLL who had easy […]

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Platelet Function Testing

Feb 11 2017

george

More on Whole Blood Aggs

Here’s additional follow-up to Heather DeVries’s February 9 whole blood lumiaggregometry discussion, which attracted comments from Bob Gosselin, Dave McGlasson, and Drs. Catherine Hayward and Emmanuel Favaloro. Dr. Favaloro references the effort to clean cuvettes and probes in the whole blood system, so I want to reassure Heather that these components are now disposable. I’m […]

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Platelet Function Testing

Feb 9 2017

george

Whole Blood Lumiaggregometry

From Heather DeVries, Indiana University Health: We currently perform our platelet aggregations using PRP, but would like to investigate whole blood aggregometry. Our pathologist feels that if we do that, we should also look into lumiaggregometry. He does agree that it would improve our sensitivity to platelet functions disorders (i.e. storage pool disease), but wanted […]

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Platelet Function Testing

Jan 5 2017

george

What is VASP-P?

Vasodilator-stimulated phosphoprotein (VASP) is a ubiquitous vertebrate intracellular protein that becomes activated via phosphorylation. Once phosphorylated, VASP triggers cell motility through its interaction with the contratile protein actin. In platelets, VASP generates pseudopod formation during platelet activation. VASP becomes phosphorylated (VASP-P) when ADP binds its platelet membrane receptor site, P2Y12. Activation requires prostaglandin E1 and […]

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Platelet Function Testing

Nov 16 2016

george

Platelet Clumps in Citrate Tube

Dear Fritsma Factor, I am a hematopathology fellow evaluating the following patient for thrombocytopenia. History and laboratory results are listed in detail below. We have encountered a situation where the patient develops platelet clumps within citrate tubes but not in EDTA. I have found only limited information regarding this phenomenon and was wondering if anyone […]

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Bleeding Disorders

Oct 22 2016

george

Correction Factor for ACD Solution

On September 28, 2016, Julia Hill asked, “Is there a standard calculation for using ACD tubes?” Her comment was appended to a 2009 entry describing HELLP syndrome, so it may have been buried deep in our database. George assumes Julia’s question relates to platelet satellitosis, which results from the action of an immunoglobulin potentiated in […]

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Platelet Function Testing

Aug 31 2016

george

Platelet Clumps on Blood Film

Susan Lemire asks, “Hi, what are most people doing when platelet clumps are found on the blood smear, but the platelet count is within normal range?” Hi, Susan, my hunch is that since we don’t review blood films when the CBC is within acceptable parameters, we probably miss some platelet clumping. CBC profiling instruments do […]

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Platelet Function Testing