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FeedbackImpacts of Common Anticoagulants on Coagulation Testing
Anticoagulants have a prominent role in patient care. However, they may interfere with associated laboratory testing.
D-dimer testing may be used in the initial evaluation for venous thromboembolisms, including deep vein thromboses and pulmonary embolisms.
Heparin-Induced Thrombocytopenia
Heparin-induced thrombocytopenia, an immune-mediated adverse effect of heparin treatment, is diagnosed based on clinical assessment and laboratory results.
Prolonged Clotting Time Evaluation
Prolonged clotting times of unclear etiology require evaluation to determine the cause and exclude clinically significant bleeding disorders.
Identifying the etiology of thrombocytopenia involves careful assessment of both clinical characteristics and the results of well-chosen laboratory tests.
Disseminated
Intravascular
Coagulation - DIC
Diagnosis of DIC involves a combination of clinical evaluation and laboratory tests such as D-dimer and fibrinogen.
Laboratory testing for functional platelet disorders is appropriate in individuals with a platelet-type bleeding pattern.
Hereditary Thrombophilia - Hypercoagulability
Thrombotic risk is multifactorial. The decision to test for hereditary thrombophilia can therefore be complicated.
Hemophilia - Factor VIII or IX Deficiency
A workup for hemophilia typically involves tests such as prothrombin time, partial thromboplastin time, mixing studies, and factor assays to identify the factor deficiency.
Uncommon factor deficiencies that may lead to abnormal bleeding include deficiencies in fibrinogen (FI), factor II (FII), FV, FVII, combined FV plus FVIII, FX, FXI, and FXIII.
Although no single laboratory test can be used to diagnose VWD, an initial panel of tests typically includes tests for von Willebrand factor antigen and activity as well as FVIII activity.
Testing for fibrinolytic disorders should be performed if there is high suspicion after exclusion of common disorders of coagulation.
Thrombotic Microangiopathies - TMA
Identification of thrombotic microangiopathy syndromes (such as thrombotic thrombocytopenic purpura) is necessary to ensure appropriate treatment.