Thrombophilia

VKA Monitoring in Hepatic Insufficiency

Here is a challenging case from Hrvoje Melinšćak sent 5-30-24: Dear George, In hepatic insufficiency there is often a prolonged basal protime, how to ensure therapeutic values of warfarin when the INR is already elevated? This is of particular concern in those with mechanical cardiac valves. Serum warfarin levels (spectrophotometry) are cumbersome and take days to […]

Is DRVVT Normalization Necessary?

The clot-based dilute Russell viper venom test (DRVVT) reagent activates the coagulation mechanism’s common pathway at the factor X (10) level, relying only on factor V, prothrombin, and fibrinogen for clot formation. The DRVVT test complements the PTT-based assay for lupus anticoagulant (LAC) detection. Because LAC is phospholipid (PL)-dependent, both assays use a minimal-phospholipid (PL) […]

Testing for the Lupus Anticoagulant: The Good, the Bad, and the Ugly

Click here for a “State of the Art Review,” Favaloro EJ, Pasalic L, Selby R. Testing for the lupus anticoagulant: The good, the bad, and the ugly. Research and Practice in Thrombosis and Haemostasis 2024; 8: DOI:https://doi.org/10.1016/j.rpth.2024.102385.

Still More on Chronically Elevated D-dimer

We’ve received an additional comment on our February 3, 2024 entry on the topic of chronically elevated D-dimer.

Lab Assays to Detect Occult Cancer in VTE

Here is a provocative article whose investigators looked for lab assays to detect cancer in patients with unprovoked venous thromboembolism: Sánchez-López V, Marín-Romero S, Ferrer-Galván M, et all. Occult cancer in patients with unprovoked venous thromboembolism: A nested case-control study. Am J Clin Pathol. 2024:aqad178. doi: 10.1093/ajcp/aqad178. Epub ahead of print. PMID: 38340336.

CAP Today: Thrombophilia Testing

Here is a January 2024 CAP Today summary of current thoughts about The Who, When, and Why of Thrombophilia Testing.

More on Chronically Elevated D-dimer

I [Geo] received this 2-1-24 email from a correspondent who had expressed concern for his isolated elevated D-dimer. This is an issue we’ve addressed in the past that prompted me to prepare a summary entitled Isolated Chronically Elevated D-dimer. Here’s the note: Hello. We had email contact in 2023 and it was about a chronically […]

VWF in Malignancy

In the Rutgers CLSC 5124 Advanced Hemostasis graduate course, a participant responded to the question, “What do both Dr. Favaloro and Dr. Henry indicate about the role of platelets in metastatic carcinoma?.” The question referred to our Coag Conversations with Dr. Emmanuel Favaloro, The Many Faces of VWF. and with Dr. Brandon Henry, What Have […]

Arterial Thrombosis

VWF in Cardiac Disorders

In the Rutgers CLSD 5124 Advanced Hemostasis graduate course, a participant responded to the question, “Show how VWF and platelets appear to be involved in cardiac insufficiency and atrial fibrillation.” The question referred to our Coag Conversation with Dr. Emmanuel Favaloro, The Many Faces of VWF. The response: VWF is a glycoprotein heavily engaged in […]

Arterial Thrombosis

Readily Measurable Products of SARS-Cov-2 Endothelial Cell Injury

This is the second in a series of discussions about the relationship between hemostasis and inflammation. These discussions were part of our Rutgers CLSC 5124 Advanced Hemostasis course that features answers provided by our participants. List the readily measurable products of SARS-Cov-2 mediated endothelial cell injury. SARS-CoV-2 is increasingly being recognized as a disease of […]

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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.

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