DVT with Thrombocytopenia

Here is a case that George heard about on Saturday, May 16. An ultrasound revealed two blood clots in a man’s leg. After two days on Coumadin and Lovenox (LMWH) his platelet count was 4,000/uL so his doctor discontinued the Coumadin. The man had been previously diagnosed with ITP and his doctor wants to arrange […]

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Anticoagulant Therapy

Sep 25 2014

george

Cepheid Factor II and V Mutations

From Dr. Joyce Low, St. Vincent’s Hospital, Sydney. We were wondering if anyone has had experience with the Cepheid combined factor V Leiden mutation and prothrombin G20210A (Xpert factor II and V) assay on the GeneXpert which was FDA-cleared in 2006. Thank you, Dr. Low, I’ve had no experience, but hope to hear from our participants. Geo.

Thrombophilia

More on HIT Testing: 4 T’s

In follow-up to Julia Witt’s July 9 post requesting information on the PIFA AB rapid test for heparin-induced thrombocytopenia, attached below is an article that defines and illustrates the 4T protocol: Lo GK, Juhl D, Warkentin TE, Igouin S, Eichler P, Greinacher A. Evaluation of pretest clinical score (4 T’s) for the diagnosis of heparin-induced thrombocytopenia in two clinical […]

Thrombophilia

Rapid HIT Test

From Julia Witt: Our healthcare system is currently looking at more efficient ways to screen for heparin-induced thrombocytopenia with thrombosis (HIT). Currently we are looking at the Akers Biosciences PIFA AB test. The literature looks good, but I wonder how many are using this test and can it be reliably used as a rule out test for […]

Thrombophilia

Does Transient PS Deficiency Cause Thrombosis?

George participates in CLSC5124E-Sp14; Advanced Hemostasis, a graduate course offered by Drs. Nadine Fydryszewski and Elaine Keohane of Rutgers University School of Biomedical and Health Sciences. The faculty also include Dr. Larry Smith and Prof.Donna Castellone. This course attracts experienced medical laboratory scientists from around the world who raise interesting questions, including this one about transient gestations protein S deficiency: A surfeit of studies […]

Thrombophilia

Inpatient Thrombophilia Testing

Another message from colleague and friend Kelly Townsend, Tricore Reference Laboratories, Albuquerque. Hi George, at one of our large teaching hospitals, we are working with the Internal Medicine department to establish “best practices” for ordering thrombophilia testing on inpatients. Has anyone out there successfully implemented guidelines they are willing to share? Any recent references would also be […]

Thrombophilia

CPT Code for SCT?

From Molly Klima, University Hospitals of Cleveland: Hi George, we are in the process of bringing up the Instrumentation Laboratory Silica Clotting Time (SCT) assay and are struggling with the CPT code. Since there is no straightforward CPT for the assay our dilemma is as follows: 85730 Thromboplastin time, partial (PTT); plasma or whole blood 85732 Thromboplastin time, partial […]

Thrombophilia

World Thrombosis Day October 13

Thanks to colleague Ali Sadeghi-Khomami PhD for his heads-up announcing theInternational Society on Thrombosis and Haemostasis‘ World Thrombosis Day launch. World Thrombosis Day will be held annually on October 13, the birthday of Rudolph Virchow, 1821, who coined the terms embolism and thrombosis. See the ISTH World Thrombosis Day page for details.

Events

Validating a Rapid HIT Assay

Charlie Muller, Helen Hayes Hospital TW, posted a question on the Medlab list, paraphrased here with his permission. He is validating the Akers PIFA Heparin/PF4 rapid assay kit for heparin induced thrombocytopenia with thrombosis, and needs a good way to validate it in addition to using Akers’ panels. Charlie’s setting is an acute rehab specialty hospital where a very large […]

Thrombophilia

Protein C and S During PE

From Yvonne Ellis, Hematology Technical Supervisor, IU Health Bedford Laboratory: George, I counseled a physician today about ordering protein C and S on a patient who has a confirmed pulmonary embolism. I told him during a clot was not the time to test for these. He did seem to have a good understanding of the workings of […]

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Thrombophilia

Thrombophilia

DVT with Thrombocytopenia

Cepheid Factor II and V Mutations

More on HIT Testing: 4 T’s

Rapid HIT Test

Does Transient PS Deficiency Cause Thrombosis?

Inpatient Thrombophilia Testing

CPT Code for SCT?

World Thrombosis Day October 13

Validating a Rapid HIT Assay

Protein C and S During PE

George Fritsma MS MLS

Cheat Sheets from George

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