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Thrombophilia

Oct 25 2013
george

Anti-PF4/Protamine HIT

Hans Zwerger, Produktspezialist at CoaChrom Diagnostica, Vienna, Austria introduced me to an important clinical issue, anti-platelet factor 4 (PF4)/protamine antibodies that are implicated in heparin-induced thrombocytopenia with thrombosis (HIT). As you know, cardiologists employ high doses of standard unfractionated heparin during coronary artery bypass graft surgery, which anesthetists and anesthesiologists measure using the activated clotting time […]
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Thrombophilia
Oct 24 2013
george

Rapid HIT Assays

Informal discussions with Ginger Weeden and Lucinda Lojka from Bio-Rad, Incmade me curious about rapid assays for the antibody that causes heparin-induced thrombocytopenia with thrombosis (HIT), anti-heparin/PF4. In North America we typically screen with one of three enzyme immunoassay (EIA) methods, from GTI Diagnostics Inc., Waukesha, WI, USA, PF4 Enhanced®: GTI PF4 Enhanced Package Insert; Hyphen Bio-med, Neuville-Sur-Oise, France, Zymutest HIA® Assay; or Diagnostica Stago, […]
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Anticoagulant Therapy
Jul 16 2013
george

Unexpected DRVVT Confirmation Results

I had the pleasure of meeting Norbert Bennattar, Directeur General of Cryopep, Montpellier, France while attending the International Society on Thrombosis and Haemostasis biennial meeting in Amsterdam, July 1–4, 2013. Mr. Bennattar posed a question I couldn’t answer. When performing the dilute Russell viper venom time (DRVVT) assay for lupus anticoagulant (LA), the operator begins with a screening assay. When prolonged […]
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Thrombophilia
Jun 10 2013
george

PNP Test for LA

Here is a challenging technical question about the platelet neutralization procedure (PNP) for identification of lupus anticoagulant (LA) from Charlene Bierl MD, PhD Director of the Clinical Laboratory. Cooper University Hospital, Camden, NJ. Dr. Bieri’s question was originally addressed to Drs. Marisa B. Marques and Jill Adamski and to specialty technologists Laura Taylor and Patti Tichenor at the University of Alabama at Birmingham Hospital Department of Laboratory Medicine. Following is […]
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Thrombophilia
May 22 2013
george

Recommended DIC Profile

From Julia Witt: In an effort to standardize our healthcare organizations, we are looking at our current disseminated intravascular coagulation (DIC) panel. All sites have different ideas. George, what are your suggestions? Hi, Julia. Please forgive some self-promotion. Our handbook, Marques MB, Fritsma GA: Quick Guide to Coagulation Testing, 2nd Edition, AACC Press, 2009 provides the following recommendations […]
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Bleeding Disorders
May 15 2013
george

Anti Phospholipid Antibody Result Interpretation

From Charles Nakar, Indiana Hemophilia and Thrombosis Center: I would like your opinion on the laboratory results below regarding a patient who recently switched providers with a history of deep venous thrombosis due to May-Thurner syndrome and possible antiphospholipid antibody syndrome. He had positive anticardiolipin antibody (ACL) screens and a positive STA-clot (x1) during the acute event […]
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Thrombophilia
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George Fritsma MS MLS

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.

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What VWD therapeutic is NOT a replacement factor?