Overview
Panel selection lookup . Academy coagulation-interpretation-workflow teaches algorithm narrative.
Classification
| Indication | Initial panel | Reflex direction (per protocol) |
|---|---|---|
| Pre-procedure screen | PT/INR, aPTT, platelets | Mixing if unexplained prolongation |
| Bleeding + normal screen | VWF Ag/activity, platelet function | Directed by bleeding history |
| Warfarin monitoring | PT/INR | Anti-Xa not for VKA |
| UFH monitoring | aPTT or anti-Xa | Institution-specific therapeutic range |
| DIC suspicion | PT, aPTT, fibrinogen, platelets, D-dimer | Serial trending; smear for schistocytes |
| VWD suspicion | VWF Ag, activity, FVIII | Multimers if type 2 suspected |
| Hemophilia suspicion | aPTT → mixing → FVIII/IX | Inhibitor titer if no correction |
Morphologic Features
Smear: schistocytes if MAHA/DIC overlap; platelet morphology for count verification.
Laboratory Characteristics
- Reagent-specific sensitivity, reference intervals institutional
Reference Intervals
All intervals per institutional EP28 verification.
Clinical and Laboratory Significance
Panels screen patterns, confirmatory testing clinician-directed.
Differential Considerations
Comparison Tables
Classification Frameworks
Laboratory Notes
- Integrate laboratory findings with clinical context; verify local reference intervals and reflex rules.
References
Authoritative textbooks, guidelines, and reviews supporting this reference entry. Verify reference intervals, critical limits, and reflex criteria against institutional protocols and current guideline editions.
Textbooks
- McPherson RA, Pincus MR. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Elsevier; 2021.
- Rodak BF, Carr JH. Rodak's Hematology: Clinical Principles and Applications. 6th ed. Elsevier; 2020.
- McKenzie SB, Williams JL. Clinical Laboratory Hematology. 4th ed. Pearson; 2022.
CLSI and Professional Guidelines
- Clinical and Laboratory Standards Institute. Collection, Transport, and Processing of Blood Specimens for Testing Plasma-Based Coagulation Assays and Molecular Hemostasis Assays. CLSI document H21-A5. CLSI; 2008.
- Clinical and Laboratory Standards Institute. Collection, Transport, and Processing of Blood Specimens for Testing Plasma-Based Coagulation Assays. CLSI document H21. CLSI.
- Clinical and Laboratory Standards Institute. Defining, Establishing, and Verifying Reference Intervals in the Clinical Laboratory; Approved Standard. CLSI document EP28-A3c. CLSI; 2010.
- Clinical and Laboratory Standards Institute. Management of Critical- and Significant-Risk Results. CLSI guideline GP47-Ed1. CLSI; 2015.
- International Society on Thrombosis and Haemostasis. Guidelines for the diagnosis of von Willebrand disease. ISTH; 2021.
WHO Publications
- World Health Organization. Haemophilia: diagnosis and management. WHO; 2020.
Frequently Asked Questions
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