Thrombophilia

Mixing Studies

A note from colleague Kathy Robinson that deserves a thorough discussion… “I am updating our mixing study procedure and have some questions…” 1. What is the lower limit at which it is useless to perform studies for both PT & PTT [APTT]? There is no firm agreement about the limit. Some perform mixes whenever the […]

Bleeding Disorders

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 […]

Quick Question Archive

July, 2020 Quick Question on Covid Coag Results

Our July, 2020 Quick Question, “What assay does your lab use to monitor Covid-19 severity?” attracted 64 responses that were nearly unanimous. Answers: Fibrin degradation products: 3 [5%] D-dimer: 53 [83%] PT and PTT: 3 [5%] Platelet count: 1 [2%] Other: 4 [6%] Several publications, especially from China, record the parallel use of FDPs and […]

ISTH Guidelines for TTP

Here are the July, 2020 ISTH diagnostic guidelines for thrombotic thrombocytopenic purpura as reported at the recent digital congress: Zheng XL, Vesely SK, Cataland SR, et al. Guidelines for the diagnosis of thrombotic thrombocytopenic purpura. J Thromb Haemost 2020;pre-pub, doi: 10.1111/JTH.15006

Covid Labs Table

Here is an updated table of hemostasis, hematology and clinical chemistry assays plus inflammatory makers used to monitor Covid infection progression. Also attached is an article detailing the the diagnostic assays; RT-PCR and serological assays: Smithgall MC, Dowlatshahi M, Spitalnik SL, Hod EA, Rai AJ. Types of assays for SARS-CoV-2 testing: a review Laboratory Medicine […]

Can Heparin Prevent Covid?

Thanks to George’s colleague Rodney Rohde, PhD, Texas State University, who posted this Contagion Live article by Grant M. Gallagher on LinkedIn entitled FDA-Approved Anticoagulant May Stop Coronavirus From Binding to Human Cells [click or tap]. This is a suprising and apparently authentic description of a non-antithrombotic Covid-preventative property of heparin, separate from heparin’s prophylactic […]

Anticoagulant Therapy

ISTH Poster: DRVVT Interferents

We recommend ISTH Poster PB0669, by Sadeghi-Khomami A, Lamont D, Boylan M, et al. Effects of Anticoagulants and Common Interfering Substances on Four Commercially Available dRVVT Assays.

Covid and Hemostasis Riley Article

For a succinct summary of hemostasis mechanisms and management in the Covid-19 infection, see Riley P. Pandemic care: The need for hemostasis testing in critically ill COVID-19 patients. MLO 5-20-20, accessed 7-7-20. Also visit Stago’s Edvantage Virtual University for their recent program, Thromboembolism in COVID-19: Laboratory Considerations by Michael P Gulseth, Pharm. D., BCPS, FMSHP, […]

Anticoagulant Therapy

Covid Lab Table

Clickor tap here for a current table of Covid lab values.

July, 2020 Quick Question: Covid

Our July 2020 Quick Question highlights the hemostasis laboratory’s responsibility in monitoring the thrombotic aspects of Covid disease progression and recovery. Please provide your answer to “What assay does your lab use to monitor Covid-19 severity?” Feel free to add comments about this critical need using the Comments link or by emailing George at [email protected].

Arterial Thrombosis

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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.

Cheat Sheets from George

Quick Question