Thrombophilia

Anticoagulation in Thrombocytopenia: Case Study

Here’s a composite case study. A 50-year-old male was treated for colon cancer and is in remission. Complications include congestive heart failure, esophageal varices, and recently diagnosed NVAF. Subsequent to chemotherapy, his platelet count has remained stable at 20–30,000/uL (RI 150–450/uL) and he experiences easy bruising. What assay would you recommend to enhance the safety […]

Bleeding Disorders

April 2025 Quick Question: How to Measure Warfarin in a LAC Patient

Our April 2025 Quick Question is a poll that asks, “How do you measure warfarin in a patient with lupus anticoagulant (LAC)?” This question is a sequel to our March 2025 question, “How do you test for lupus anticoagulant?” that references the ISTH‘s most recent LAC guidelines, Devreese KMJ, Bertolaccini ML, Branch DW, et al. […]

Lupus Anticoagulant

March 2025 Quick Question: LAC Testing Outcome

Our March 2025 Quick Question asked, “How do you test for lupus anticoagulant?” The question drew 38 responses. DRVVT Screen/Confirm only: 4 (11%) PTT Screen/Confirm only: 2 (5%) First DRVVT S/C then PTT S/C if pos: 1 (3%) First PTT S/C then DRVVT S/C if pos: 3 (7%) Both DRVVT S/C & PTT S/C: 27 […]

Lupus Anticoagulant

Caplacizumab Immune-mediated TTP Clinical Efficacy Report

Thanks to colleague X. Long Zheng, MD, for his LinkedIn heads-up announcing the 31 March 2025 eClinicalMedicine release of Caplacizumab use in immune-mediated thrombotic thrombocytopenic purpura: an international multicentre retrospective Cohort study (The Capla 1000+ project). This pivotal open-access article compares patient mortality rate and the response rate to caplacizumab (Cablivi®) to standard care.

March 2025 Quick Question: LAC Testing

The March 2025 QQ is now available to answer, it is a poll to learn how we perform lupus anticoagulant testing. If you have an alternative, please answer in the Comments section below.

Elevated Protein C and Protein S

This question arrived on Wednesday, January 15, 2025, from Soha Abuelela: “I have a protein C level above 150% and a protein S level above 200%. What is the interference and significance?” We assay for protein C and protein S deficiency when a person has experienced an unprovoked venous thromboembolism (VTE, clotting) event such as […]

Agent Orange and Lupus Anticoagulant?

I (Geo) received an 11-7-24 message from Steve Montag, whose oncologist states that his lupus anticoagulant is “more than likely” caused by Agent Orange exposure. We could only find a single reference associating antiphospholipid antibodies to the Gulf War Syndrome, but nothing linking Agent Orange. Please comment below if you have seen this or can […]

Lupus Anticoagulant Testing

Anfal Helu asked: I have a question regarding the screening and confirmatory testing for the lupus anticoagulant (LA). Recently, a young female pt was clotting everywhere after a hospital visit for a status epilepticus attack during which she was intubated and placed on mechanical ventilation. She had 2 pulmonary emboli, 2 MI, ischemic colitis, renal […]

World Thrombosis Day, October 13

Dear George, As World Thrombosis Day (WTD) approaches on October 13, we’re excited to share new resources to help make this year’s campaign more impactful. Your participation is essential to raising awareness about thrombosis, and we are grateful for your continued support. To help you engage your community, we’ve added new tools and materials. New […]

A Molecular Approach to Assess Platelet Hyperreactivity

Friend Ed Groenendal forwarded this UPI summary of a molecular approach correlating evidence of hyperresponsive platelets to major adverse cardiac or limb events. The investigators started with aggregometry-defined platelet hyperreactivity to apply a transcriptome-based platelet reactivity expression score (PRESS). Click below to see the detailed open-access article describing the development and application of the PRESS. […]

Antiplatelet Therapy

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George Fritsma is a medical laboratory scientist, educator, and author. George holds faculty appointments with Rutgers University and Michigan State University, and is a member of the International Society on Thrombosis and Hemostasis, American Association of Clinical Chemists, and American Society for Clinical Laboratory Science.

Cheat Sheets from George

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