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[Incidental finding of pathological coagulation parameters].
B Luxembourg1, E Lindhoff-Last
1Institut für Transfusionsmedizin und Immunhämatologie, DRK-Blutspendedienst Baden-Württemberg - Hessen, Universitätsklinik Frankfurt, Sandhofstr. 1, 60528, Frankfurt a. M., Deutschland, b.luxembourg@blutspende.de.
Pathological coagulation tests can indicate serious bleeding or clotting disorders, or be due to lab errors. This guide helps interpret abnormal results, considering anticoagulants and D-dimer levels for accurate diagnosis.
Area of Science:
- Clinical Pathology
- Hematology
- Diagnostic Medicine
Context:
- Coagulation parameters are crucial for diagnosing bleeding and clotting disorders.
- Abnormal results may stem from various causes, including preanalytical errors, in vitro phenomena, or underlying diseases.
- Modern anticoagulants significantly influence coagulation test results.
Purpose:
- To provide an overview of potential pitfalls in coagulation diagnostics.
- To list differential diagnoses for pathological coagulation parameters.
- To describe diagnostic steps for clarifying abnormal coagulation test results.
Summary:
- This article reviews common coagulation tests like platelet count, prothrombin time, activated partial thromboplastin time (aPTT), and fibrinogen.
- It discusses the impact of various anticoagulants (heparin, vitamin K antagonists, direct oral anticoagulants) on these parameters.
- It also addresses elevated D-dimer levels, emphasizing their limited specificity and utility in ruling out venous thromboembolism when normal.
Impact:
- Aids clinicians in accurately interpreting abnormal coagulation test results.
- Improves diagnostic accuracy by differentiating true pathological findings from analytical interferences.
- Enhances patient management by guiding appropriate further investigations and treatment decisions.
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