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 […]

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Thrombophilia

Mar 10 2014

george

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 […]

Thrombophilia

Rivaroxaban and Homocysteine

From our frequent contributor Crystal Azevedo, Eastern Maine Health System: Hello George, I am working up more patients taking the new directed oral anticoagulants (NOACs) for therapy. Is there a relationship between rivaroxaban and an elevated plasma homocysteine level? I have seen this more than once and I’m curious. Thanks! Hi, Crystal, this is an unexpected and […]

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Anticoagulant Therapy

Jan 9 2014

george

PS Antigen Comparison Studies

Dear George, I work in a large midwest reference laboratory. We are looking at bringing in the Prot S free latex test. Have you seen any comparison studies between manufacturers’ kits that I could go out on the internet and read? Thanks, Pamela L. Pool, Section Specialist for Coagulation. Hello, Pamela, thank you for your question. […]

Thrombophilia

More on Shortened PTT

From Anita Elledge, MT (ASCP), blood bank/coagulation supervisor, Sierra Vista Regional Health Center, AZ: Our coagulation testing is done on a Stago Compact instrument. The linear range is 20–200 s for the activated partial thromboplastin time (APTT, PTT). We have a policy that any PTT result <22 s must be redrawn, not just rerun the same sample, […]

Screening Assays

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 […]

Thrombophilia

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

Thrombophilia

Inpatient Thrombophilia Testing

CPT Code for SCT?

World Thrombosis Day October 13

Validating a Rapid HIT Assay

Protein C and S During PE

Rivaroxaban and Homocysteine

PS Antigen Comparison Studies

More on Shortened PTT

Anti-PF4/Protamine HIT

Rapid HIT Assays

George Fritsma MS MLS

Cheat Sheets from George

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