Jan 31 2021

george

Jan, 2021 QQ: CFX Answers

Our January, 2021 Quick Question asked, “How does your facility monitor warfarin in an atrial fibrillation [AFIB] patient with lupus anticoagulant [LAC]? The answers were… PT–INR; it is valid in LAC [33%] Chromogenic factor X [10, CFX] [33%] Chromogenic anti-factor Xa [23%] None: we switch to a DOAC [11%] Our question attracted too small a […]

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Anticoagulant Therapy

Dec 1 2020

george

December 2020 Quick Question: Emicizumab

Our December, 2020 Quick Question addresses the uncommon incidence of breakthrough bleeds in hemophilia A patient who are being treated with emicizumab [HEMLIBRA], the immunotherapeutic that bypasses factor VIII. Treatment may become an issue in severe hemophilia in which patients develop inhibitors. See our November 29 post, Emicizumab Laboratory Assay Review [click] for some hints […]

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Bleeding Disorders

Dec 1 2020

george

November 2020 QQ: VWF Activity Assay Responses

Our November, 2020 Quick Question attracted 37 participants. Here is the stem: “Which VWF activity assay is preferred at your facility [check 10-31-20 post]?” The selections were… VWF:RCo: 58% [21] VWF:GP1bR: 3% [1] VWF:GP1gM: 14% [5] VWF:Ab: 3% [1] VWF:CBA: 22% [8]* The time-honored Ristocetin cofactor assay remains the most prevalent of VWF activity assays. […]

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Bleeding Disorders

Oct 31 2020

george

October 2020 Quick Question: Inflammatory Marker Results

Our October, 2020 Quick Question was, “What inflammation assay does your lab use to assess SARS-CoV-2 progression?” The  question attracted 223 votes, a record turnout, but the answers were phrased in a way that directed us to a single answer! Here are the results: CRP: 7% [16] ESR: 0% Ferritin: 1% [2] IL-6: 3% [7] […]

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Quick Question Archive

Oct 1 2020

george

October 2020 Quick Question: Inflammation

Our October Quick Question is selected from the many open questions we received during our September 15 webinar. “Covid-Associated Coagulopathy: A Conversation about Controversies and Confusion” [click] featuring Andrew Goodwin, MD, CLIA Medical Director, University of Vermont Medical Center and Laboratory Services and Section Medical Director of the Thrombosis and Hemostasis Laboratory. In our Quick […]

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Quick Question Archive

Oct 1 2020

george

Sept, 2020 Quick Question Reponse: Fibrinolysis

Here are our responses to the September, 2020 Quick Question, wich attracted 51 participants. How does your facility measure fibrinolysis? Plasminogen: 3 [5%] Tissue plasminogen activator [TPA]: 1 [2%] Plasminogen activator inhibitor 1 [PAI-1]: 1 [2%] Thromboelastograph [TEG]: 10 [20%] Rotational thromboelastometry [ROTEM]: 36 [71%] As we speculated the first three measures of fibrinolysis are […]

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Fibrinolysis

Aug 28 2020

george

Sept, 2020 Quick Question: Fibrinolysis

Introducing our September, 2020 Quick Question, a laboratory service poll, “How do you measure fibrinolysis?” Please select your answer on the right or if you don’t see the answer you are looking for, please add your comment below.

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Fibrinolysis

Aug 28 2020

george

August, 2020 Quick Question on D-dimer Results

Our August, 2020 Quick Question asks, “What condition may account for a chronically elevated D-dimer?” We’ve had 59 respondents with a broad distribution of results: Plasma human anti-mouse antibody: 7% [4] Rheumatoid factor: 14% [8] Chronic low-grade inflammation: 24% [14] Venous thromboembolic disease: 17% [10] Disseminated intravascular coagulation: 34% [20] Other, please comment: 4% [3] […]

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Fibrinolysis

Jul 31 2020

george

Case: Consistent D-dimer Elevation

A 35-YO woman experiences fatigue. The attached table [click] illustrates typical laboratory findings consistent over 18 months: reduced MCV, MCH, and MCHC, and mildly elevated ESR, CRP, and D-dimer. She reports that she has sickle-thalassemia, which accounts for her slightly decreased RBC indices. Please refer to our August Quick Question on the right, and choose […]

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Quick Question Archive

Jul 1 2020

george

June, 2020 QQ: Protein S Deficiency Results

Our June, 2020 Quick Question, “What assay does your lab use as an initial protein S screen?” attracted 37 answers, implying that not many of us are testing routinely for protein S deficiency. Here are the answers: Total protein S antigen 3% [1] Free protein S antigen 43% [16] Clot-based protein S activity: 30% [11] […]

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Quick Question Archive