Paediatric reference intervals for common coagulation assays in Chinese children as performed on the STA‐R coagulation analyzer

Liu, Junjie; Dai, Yanpeng; Yuan, Enwu; Li, Yushan; Wang, Quanxian; Wang, Linkai; Su, Yanhua

doi:10.1111/ijlh.13098

Cited by 7 publications

(7 citation statements)

References 16 publications

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“…Using the STA-R coagulation analyzer (China), HemosIL Assays on ACL TOP Hemostasis Testing Systems (France), and the Sysmex CA-1500 System in parallel with the Behring BCS System using reagents from Siemens (Dutch) lower fibrinogen levels and aPTT as well as TCT prolongation were observed, attributable to decreased concentrations of clotting factors in younger children. 8,10,17 Variable PT RIs are reported in the literature; our findings and results from the Chinese group observing significant differences in PT levels by age contrast with the French study. Potential explanations for observed disparity in PT results between reagents include different sensitivities to factor levels or alternate endpoints (eg, maximum acceleration versus maximum top speed).…”

Section: Discussioncontrasting

confidence: 69%

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Pediatric Thromboelastograph 6s and Laboratory Coagulation Reference Values

Moynihan

Johnson

Rane

et al. 2021

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Specific reference intervals (RIs) facilitate accurate interpretation of results. Coagulation assay results may vary by demographics and also between reagents and analyzers used. Current Thromboelastograph 6s (TEG 6s) Hemostasis Analyzer RIs were generated from adult samples. Objective.— To generate reagent analyzer-specific pediatric RIs for TEG 6s and coagulation parameters. Design.— A prospective, observational, single-center study of healthy children undergoing general anesthesia (January 3, 2017 to January 3, 2019). Venous blood samples were obtained for TEG 6s (Kaolin, Kaolin-Heparinase, Rapid and Functional Fibrinogen assays) and coagulation parameters (activated partial thromboplastin time, prothrombin time, thrombin clotting time, Echis time, antithrombin activity, and fibrinogen concentration using Instrumentation Laboratory ACL-TOP analyzers). Differences between activated partial thromboplastin time and prothrombin time reagents were investigated using mixed-effects regression, comparing maximum coefficients-of-variation with assay-specific allowable variation. RIs (lower/upper limits 2.5th of 97.5th percentiles) were generated using the following 2 methods: within discrete age-groups (neonates [<1 month], infants [1 month–1 year], young children [1–5 years], older children [6–10 years], and adolescents [11–16 years]), and modeled as functions of age and/or sex using quantile regression, including significant fractional polynomial and interaction terms. Results.— Variation between prothrombin time and activated partial thromboplastin time assays using different reagents was clinically significant. Reagent-analyzer specific pediatric RIs were generated using data from 254 children. Discrete and model-based RIs varied by age for all coagulation parameters and TEG 6s variables in all assays. Conclusions.— We report reagent-analyzer specific pediatric RIs for TEG 6s and coagulation parameters. Observed variation reinforces recommendations for laboratory-specific RIs. These findings improve accuracy of interpretation of clinical results, provide a foundation for comparison and validation of tests in pathology and illustrate feasibility and advantages of model-based RI approaches.

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Section: Discussioncontrasting

confidence: 69%

“…and analyzers. 5,6,[8][9][10]17 However, many pediatric RIs are still derived from adults, often using different laboratory techniques and all are estimated using standard, discrete age groups. 11,13,14 A paucity of literature measures the extent to which results from different technical conditions can be compared.…”

mentioning

confidence: 99%

Pediatric Thromboelastograph 6s and Laboratory Coagulation Reference Values

Moynihan

Johnson

Rane

et al. 2021

Archives of Pathology &Amp; Laboratory Medicine

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“…The concentrations of most coagulation proteins vary significantly with age. 9 It was reported that aPTT was prolonged in infants 9 and children 10 compared with adults.…”

Section: Resultsmentioning

confidence: 99%

“…Second, the individuals in the present study were aged from 20 to 79 years old. It was reported that the median time of aPTT and TT was significantly prolonged in all pediatric age groups compared with the adult group in a previous study10 ; therefore, reference values of the individuals aged below 20 years remained to be determined. Finally, due to race-based differences in aPTT,21 the reference range of coagulation assays in a healthy population in the Chaoshan region may be different from that in other populations in China.…”

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confidence: 93%

Reference intervals for coagulation tests in adults with different ABO blood types

Chen

Dai

Cao

et al. 2022

Clinical Laboratory Analysis

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Introduction: Coagulation tests are affected by many factors, such as age, race, and gestation. Although coagulation test results vary by ABO blood type, reference intervals of different ABO blood groups remain to be determined. This study aims to investigate the reference ranges of coagulation tests for different ABO blood groups in the Han population in South China. Methods: A retrospective study was conducted in the First Affiliated Hospital of Shantou University Medical College. In all, 9600 individuals aged between 20 and 79 years were included. Coagulation tests, including prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (aPTT), thrombin time, and fibrinogen, were performed.Results: There was a significant difference in PT, INR, and aPTT among ABO blood groups. PT and INR varied slightly between ABO blood groups. There was a higher aPTT value in individuals in the O blood group than in those in non-O blood groups, in both males and females across the included age range. No differences were found in thrombin time and fibrinogen between the ABO blood groups. Conclusion:The study provides reference data on coagulation tests from ABO blood groups in South China. The established reference intervals specific to ABO blood type, sex, and age may improve clinical decisions based on coagulation tests.

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“…In addition, results of the coagulation assays are highly age-dependent and must be used to ensure the correct evaluation of coagulation assays in children, especially in the first year of life [ 37 ]. For newborns, coagulation factors are already low and gradually increase to adult levels after 6 months [ 38 – 40 ].…”

Section: Discussionmentioning

confidence: 99%

Congenital hemophilia A with low activity of factor XII: a case report and literature review

Lei¹,

Cui²,

Feng³

2021

Ital J Pediatr

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Background Congenital hemophilia A is a recessive inherited hemorrhagic disorder. According to the activity of functional coagulation factors, the severity of hemophilia A is divided into three levels: mild, moderate and severe. The first bleeding episode in severe and moderate congenital hemophilia A occurs mostly in early childhood and mainly involves soft tissue and joint bleeds. At present, there are limited reports on severe congenital hemophilia A with low factor XII (FXII) activity during the neonatal period. Case presentation A 13-day-old neonate was admitted to the hospital with hematoma near the joints of both upper arms. Coagulation tests showed he had low activity of factor VIII (FVIII) and FXII. He was diagnosed with congenital hemophilia A and treated with human coagulation factor VIII (recombinant FVIII). Although the hematoma became smaller, FVIII activity was only increased to a certain extent and FXII activity decreased gradually. Unfortunately, the child responded poorly to recombinant human coagulation factor VIII and his guardian rejected prophylactic inhibitors and genetic testing and refused further treatment. Three months later, the child developed intracranial hemorrhage (ICH) due to low FVIII activity. Conclusions In hemophilia A, the presence of FVIII inhibitors, drug concentration and testing are three important aspects that must be considered when FVIII activity does not reach the desired level. Early positive disease treatment and prophylaxis can decrease the frequency of bleeding and improve quality of life. We recommend that pregnant women with a family history of hemophilia A undergo early prenatal and neonatal genetic testing.

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Paediatric reference intervals for common coagulation assays in Chinese children as performed on the STA‐R coagulation analyzer

Cited by 7 publications

References 16 publications

Pediatric Thromboelastograph 6s and Laboratory Coagulation Reference Values

Pediatric Thromboelastograph 6s and Laboratory Coagulation Reference Values

Reference intervals for coagulation tests in adults with different ABO blood types

Congenital hemophilia A with low activity of factor XII: a case report and literature review

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