New developments in laboratory diagnosis and monitoring

Thrombin generation in patients with a bleeding tendency of unknown origin

“…However, the use of thrombin generation tests as a tool for identifying a hypocoagulable state and for evaluating the bleeding risk and clinical phenotype in patients with coagulation disorders is still not established in routine practice, because these tests are not yet standardized with respect to preanalytical and analytical conditions [3,[17][18][19]. Of particular importance in order to obtain reproducible and meaningful results are adequate sampling conditions, manipulation of plasma samples and performing measurements under standardized conditions.…”

“…The accumulation of thrombin at sites of vascular injury provides an important mechanism for the gathering of platelets and the formation of a growing haemostatic plug. Recent advances in laboratory technologies gave rise to the development of new assays to measure the in-vitro thrombin generation, which reflects the overall coagulation potential [3][4][5][6].…”

Enfermedad de von Willebrand, biología molecular y diagnóstico

“…Los multímeros son vistos mediante autorradiografía después de la incubación con anticuerpo contra el VWF marcados con inmunoperoxidasa o fosfatasa alcalina. Esta técnica permite el diagnóstico con certeza de los diferentes tipos de la enfermedad de von Willebrand según su patrón de multímeros y tiene lugar solo en los laboratorios de referencia 24,25,30,31 .…”

Laboratory and Quality Control of Assays

“…Other cases have a reduced one-stage FVIII but normal two-stage or chromogenic activity [27], and in many of these the detection of abnormality has arisen during the investigation of a prolonged APTT as a chance finding during presurgical screening with only a small proportion arising from investigations for a possible bleeding disorder [25]. Other cases have a reduced one-stage FVIII but normal two-stage or chromogenic activity [27], and in many of these the detection of abnormality has arisen during the investigation of a prolonged APTT as a chance finding during presurgical screening with only a small proportion arising from investigations for a possible bleeding disorder [25].…”

“…It is recommended that all hemophilia centers include a chromogenic or two-stage assay in addition to a one-stage technique, and that this should be performed in subjects with normal onestage FVIII in the presence of a personal or family history consistent with mild hemophilia A [1, 25].…”