Laboratory diagnosis: women with bleeding disorders.45
| I. Screening Laboratory Studies: . | |
|---|---|
| Hematologic tests: | CBC, differential, platelet count |
| Endocrinologic tests: | Prolactin, FSH, progesterone (mid-cycle) |
| Liver function tests: | SGOT, SGPT, alkaline phosphatase, bilirubin |
| Kidney function tests: | BUN, creatinine, urinalysis |
| Gynecologic tests: | Pelvic ultrasound |
| I. Screening Laboratory Studies: . | |
|---|---|
| Hematologic tests: | CBC, differential, platelet count |
| Endocrinologic tests: | Prolactin, FSH, progesterone (mid-cycle) |
| Liver function tests: | SGOT, SGPT, alkaline phosphatase, bilirubin |
| Kidney function tests: | BUN, creatinine, urinalysis |
| Gynecologic tests: | Pelvic ultrasound |
| II. Screening Coagulation Laboratory Studies: . | |||
|---|---|---|---|
| Coagulation Pathway . | Coagulation Abnormality . | Congenital Deficiency . | Acquired Coagulopathy . |
| Intrinsic Pathway (LAC) | Prolonged APTT | FXI, XII, PK | Lupus anticoagulant |
| HMW-K | Specific anticoagulants | ||
| FVIII, IX | Anti-VIII | ||
| FVIII carrier | Anti-V | ||
| FIX carrier | Heparin | ||
| von Willebrand disease | Acquired von Willebrand disease | ||
| Extrinsic Pathway | Prolonged PT | FVII | Vitamin K Deficiency |
| Common Pathway | Prolonged PT, APTT | FI, II, V, X | Vitamin K Deficiency |
| Liver Disease, DIC | |||
| II. Screening Coagulation Laboratory Studies: . | |||
|---|---|---|---|
| Coagulation Pathway . | Coagulation Abnormality . | Congenital Deficiency . | Acquired Coagulopathy . |
| Intrinsic Pathway (LAC) | Prolonged APTT | FXI, XII, PK | Lupus anticoagulant |
| HMW-K | Specific anticoagulants | ||
| FVIII, IX | Anti-VIII | ||
| FVIII carrier | Anti-V | ||
| FIX carrier | Heparin | ||
| von Willebrand disease | Acquired von Willebrand disease | ||
| Extrinsic Pathway | Prolonged PT | FVII | Vitamin K Deficiency |
| Common Pathway | Prolonged PT, APTT | FI, II, V, X | Vitamin K Deficiency |
| Liver Disease, DIC | |||
| III. Screening Platelet Function Studies: . | |||
|---|---|---|---|
| Platelet Plug Pathway . | Platelet functional Defect . | Congenital Platelet Defect . | Acquired Platelet Defect . |
| Platelet Adhesion | Platelet adhesion Ristocetin agglutination | Bernard-Soulier syndrome | Immune thrombocytopenic purpura Myeloproliferative disorders |
| Platelet Aggregation | Aggregation with epi, ADP collagen thrombin | Glanzmann thrombasthenia | Cardiopulmonary bypass Chronic renal disease Heparin |
| Platelet Secretion | ATP:ADP ratio | Storage pool disease | |
| von Willebrand Ag | vW:Ag: ELISA Laurell immunoassay | von Willebrand disease | Acquired von Willebrand disease |
| vWF Activity | FVIII:C, RCoF:VIII Multimers (SDS PAGE) Collagen binding assay | ||
| Vessel-platelet interaction | Closure time/bleeding time | All above disorders | Aspirin, NSAIDs, antibiotics Platelet inhibitory drugs, ETOH |
| III. Screening Platelet Function Studies: . | |||
|---|---|---|---|
| Platelet Plug Pathway . | Platelet functional Defect . | Congenital Platelet Defect . | Acquired Platelet Defect . |
| Platelet Adhesion | Platelet adhesion Ristocetin agglutination | Bernard-Soulier syndrome | Immune thrombocytopenic purpura Myeloproliferative disorders |
| Platelet Aggregation | Aggregation with epi, ADP collagen thrombin | Glanzmann thrombasthenia | Cardiopulmonary bypass Chronic renal disease Heparin |
| Platelet Secretion | ATP:ADP ratio | Storage pool disease | |
| von Willebrand Ag | vW:Ag: ELISA Laurell immunoassay | von Willebrand disease | Acquired von Willebrand disease |
| vWF Activity | FVIII:C, RCoF:VIII Multimers (SDS PAGE) Collagen binding assay | ||
| Vessel-platelet interaction | Closure time/bleeding time | All above disorders | Aspirin, NSAIDs, antibiotics Platelet inhibitory drugs, ETOH |