Investigation of Bleeding Disorders Dense Tubular System Dense Body

ADP Serotonin
ATP Calcium

Microtubular System

Plasma Membrane
PF 3
Glycogen

Bleeding Episode Patient History & Physical Family History Alpha Granules
Exterior Coat
(Glycocalyx)
PF4 Fibrinogen
Factor V Fibronectin
Factor VIII R:ag Thromboglobulin Mitochondria
(vWF)

Surface
Cytosol Connecting System
Factor XIII

PT aPTT Fibrinogen Bleeding Time Platelet

Count

Prolonged Normal Prolonged Normal Normal Low Normal Abnormal

Normal
TCT TCT

Mixing Studies Platelet Aggregation with ADP, Epinephrine,

with Plasma Collagen, Ristocetin, Arachidonic Acid
Normal Prolonged Normal Prolonged or Serum Abnormal

Factor VIII: low Platelet Aggregation

History of Administration of: vWf: low or high and release High Low
Not Corrected Corrected vWF Function
Coumarin Heparin vWf multimers: abnormal
vWF Antigen
Thrombolytic Agents Ristocetin co-factor: low
VIII:C
VON WILLEBRAND DISEASE
Bone Marrow Thrombocytopenia
Yes No Lupus Specific Evaluation Evaluations
Heparin Assay Confirmation Factor
Abnormal
Assays Assay
Ristocetin: low Absent (except for
Coumarin Liver Function
ristocetin)
Effect Tests Present Negative Immune Non-immune
GLANZMAN'S
Abnormal von Willebrand Disease Platelet size Thrombocytopenia Thrombocytopenia
Positive Negative THROMBASTHENIA
(glycoprotein
Normal Abnormal ADP, epinephrine: IIb/IIIa)
Fibrinogen Factor Deficiency absent 2nd wave Investigate: Investigate:
Antiphospholipid Specific Normal Collagen: impaired
Vitamin K Deficiency Drug-induced Thrombocytopenia TTP
Antibody Factor
Vitamin K Liver Liver Disease ITP (Platelet antibodies) HUS
Syndrome Inhibitor
Administered Disease Wafarin Therapy Large Uremia
(Lupus Granule contents,
Anticoagulant) BERNARD-SOULIER DIC
Thromboxane A2
(glycoprotein Ib) Infection
Normal Low
Correction No Correction
Foreign Substance Body recognizes
binds to surface this as
platelet membrane foreign
antigen

Vitamin K DIC Fibrin Split Dysfibrinogenemia Thromboxane: dec. synthesis

Deficiency Products Hypofibrinogenemia Normal results ARACHIDONATE DISORDER
Platelet
Antibody

Afibrinogenemia SECRETION DEFECT (release of oxygenation)

1:1 Mix Fibrin Split Product (? cause, "aspirin-like")
Foreign
Substance Platelet
DIC

Granules: low ATP

Correction No Correction
and serotonin See several-fold
increase in
STORAGE POOL DISEASE PAIgG

For information on Helena's complete line of Hemostasis products, call Toll Free 800-231-5663
Factor VII Factor VII Inhibitor An educational service of: Clear through
splenic lysis
Assay Lupus
Hemostasis
Helena Laboratories
Helena Products
Systems
Beaumont, Texas

Prothrombin Time aPTT Factor Assays Calibrators & Controls Inhibitors Platelets Instruments
Thromboplastin Reagent aPTT-SA (Cat. No. 5387, Congenital Factor PT, aPTT, Fibrinogen Assays Chrom Z AT (Cat. No. 5240) ADP (Cat. No. 5366) Cascade M (Cat. No. 1710)
(Cat. No. 5380, 5381,5382) 5388,5389) Deficient Substrate (Cat. No. 5186, 5187, 5183) AT-III QUIPlate Kit (Cat. No. 5200) EPI (Cat. No. 5367) Cascade M4 (Cat. No. 1711)
Thromboplastin-MI Reagent Kits aPTT-ES (Cat. No. 5386, (Cat. No. 5190-5197) Hep-Trol (Cat. No. 5189) PC Antigen Rocket Plates (Cat. No. 5357) Collagen (Cat. No. 5368) THOR (Cat. No. 1450, 1451)
(Cat. No. 5271, 5272,5273, 5274) 5396,5397) Immunodepleted Factor S.A.C.-1 & S.A.C.-2 PS Antigen Rocket Plates (Cat. No. 5359) Ristocetin (Cat. No. 5199) PACKS-4 (Cat. No. 1471, 1472)
Thromboplastin-LI Kit CaCl2 (Cat. No. 5386) Deficient Substrate (Cat. No. 5301, 5302) PC ELISA (Cat. No. 5291) AA (Cat. No. 5364)
Fibrinogen
(Cat. No. 5269) (Cat. No. 5791, 5793, 5794) S.A.R.P. (Cat. No. 5185) PS ELISA (Cat. No. 5292) Fibrinogen Assay Kit
Chrom Z FVIII (Cat. No. 5241) Chrom Z PC (Cat. No. 5243) (Cat. No. 5376)