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Diagnostic approach to inherited bleeding disorders

  • Giuseppe Lippi , Massimo Franchini und Gian Cesare Guidi
Veröffentlicht/Copyright: 24. Januar 2007
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Clinical Chemistry and Laboratory Medicine (CCLM)
Aus der Zeitschrift Band 45 Heft 1

Abstract

The appropriate development of hemostasis encompasses a delicate equilibrium between anti- and prothrombotic forces developing during three distinct phases (primary hemostasis, coagulation and fibrinolysis) that are closely linked to each other and precisely regulated to close vessel wounds, promote vascular healing and maintain vessel patency. Imbalance in each of these systems produces either hemorrhagic or thrombotic disorders. Inherited bleeding disorders, caused by quantitative or qualitative alterations of either platelets or plasma proteins involved in blood coagulation and fibrinolysis, may lead to serious and lifelong bleeding conditions, the severity of which is inversely associated with the degree of the underlying defect. Rapid and reliable identification of these pathologies is worthy of focus to allow the adoption of appropriate substitutive or supportive antihemorrhagic therapies. Evaluation of the hemorrhage-prone patient requires careful recording of the medical history, attention to pertinent physical findings and the discretionary use of laboratory resources. Owing to the low diagnostic efficiency of clinical history and examination, an appropriate and reliable laboratory approach, encompassing first- and second-line testing, is essential to screen, diagnose and monitor patients with bleeding diatheses. As both the analytical sensitivity and responsiveness of traditional coagulation assays to different abnormalities differ widely, each laboratory should establish individual guidelines based on field experience and on reagent and instrument characteristics. Emerging evidence indicates that the implementation of global coagulation tests, such as the thrombin generation assay and clot waveform analysis, would provide additional information for clinical decision-making for patients with inherited bleeding disorders.

Clin Chem Lab Med 2007;45:2–12.

Keywords: coagulation testing; hemophilia; inherited bleeding disorders; laboratory testing; platelets
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Corresponding author: Prof. Giuseppe Lippi, Istituto di Chimica e Microscopia Clinica, Dipartimento di Scienze Morfologico-Biomediche, Ospedale Policlinico G.B. Rossi, Piazzale Scuro, 10, 37121 Verona, Italy Fax: +39-045-8201889,

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Published Online: 2007-01-24
Published in Print: 2007-01-01

©2007 by Walter de Gruyter Berlin New York

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https://doi.org/10.1515/CCLM.2007.006
Schlagwörter für diesen Artikel
coagulation testing; hemophilia; inherited bleeding disorders; laboratory testing; platelets

Artikel in diesem Heft

  1. CCLM: Bringing advances in laboratory medicine to the “New World”
  2. Diagnostic approach to inherited bleeding disorders
  3. Linking laboratory and medication data: new opportunities for pharmacoepidemiological research
  4. Association between polymorphisms of ACE, B2AR, ANP and ENOS and cardiovascular diseases: a community-based study in the Matsu area
  5. Anti-thyroid-stimulating hormone receptor antibodies determined by second-generation assay
  6. Serum levels of granulocyte colony-stimulating factor (G-CSF) and macrophage colony-stimulating factor (M-CSF) in pancreatic cancer patients
  7. Surrogate markers of insulin resistance in assessing individuals with new categories “prehypertension” and “prediabetes”
  8. Evaluation of pre-analytical, demographic, behavioural and metabolic variables on fibrinolysis and haemostasis activation markers utilised to assess hypercoagulability
  9. Hyperhomocysteinaemia and immune activation in patients with cancer
  10. The effect of homocysteine reduction by B-vitamin supplementation on inflammatory markers
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Heruntergeladen am 1.10.2025 von https://www.degruyterbrill.com/document/doi/10.1515/CCLM.2007.006/html?lang=de
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