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Laboratory investigation of hypercoagulability
1Division of Cell Biology, Hemostasis and Thrombosis Research, Walt Disney Memorial Cancer Institute at Florida Hospital, Altamonte Springs, USA.
Seminars in Thrombosis and Hemostasis
|May 14, 1998
Summary
Laboratory testing for thrombophilia has advanced, with available assays identifying causes for 40-60% of idiopathic thrombosis cases. Further research into coagulation and fibrinolysis defects is ongoing to improve diagnosis.
Area of Science:
- Hematology
- Clinical Pathology
- Coagulation Science
Background:
- Laboratory investigation of thrombophilia has historically lagged behind bleeding disorders.
- Advances in understanding coagulation mechanisms have increased clinical laboratory interest in thrombophilia.
- The need for comprehensive thrombophilia diagnostics is critical for patient management.
Purpose of the Study:
- To review current laboratory investigations for thrombophilia.
- To highlight the utility of available assays in diagnosing inherited and acquired thrombotic conditions.
- To discuss the ongoing development of novel diagnostic markers for hypercoagulable states.
Main Methods:
- Review of widely available laboratory assays for thrombophilia.
- Assessment of diagnostic yield for common thrombophilia work-ups.
- Discussion of emerging laboratory tests for hypercoagulable states.
Main Results:
- Assays for activated protein C resistance, antithrombin, protein C, protein S deficiencies, and antiphospholipid antibodies are standard in idiopathic thrombosis work-ups.
- These standard tests explain thrombosis in 40-60% of patients.
- Abnormalities in fibrinogen and fibrinolysis, though less common, may also contribute to thrombosis.
Conclusions:
- Current laboratory investigations effectively identify causes of thrombophilia in a significant patient subset.
- Ongoing development of new diagnostic markers promises to further enhance the understanding and diagnosis of hypercoagulable states.
- Despite advancements, the acceptance and implementation of novel laboratory approaches remain a challenge.