Test ID: ALBLD    
Bleeding Diathesis Profile, Limited, Plasma

Detection of the more common potential causes of abnormal bleeding (eg, factor deficiencies/hemophilia, von Willebrand disease, factor-specific inhibitors) and a simple screen to evaluate for an inhibitor or severe deficiency of factor XIII (rare)

This test is not useful for assessing platelet function (eg, congenital or acquired disorders such as Glanzmann thrombasthenia, Bernard-Soulier syndrome, storage pool disease, myeloproliferative disease, associated platelet dysfunction), which requires fresh platelets

Initial testing includes: prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (bovine), fibrinogen, D-dimer, coagulation factor VIII activity assay, coagulation factor IX assay, von Willebrand factor antigen, von Willebrand factor (VWF) activity, factor XIII screen, and limited bleed profile interpretation.

If PT is >13.9 seconds, then PT mix will be performed at an additional charge.

If APTT is > or =38 seconds, then APTT mix and dilute Russell viper venom time (DRVVT) will be performed at an additional charge.

If DRVVT ratio is > or =1.20, then DRVVT mix and DRVVT confirm will be performed at an additional charge.

If thrombin time is > or =25.0 seconds, then reptilase time will be performed at an additional charge.

If fibrinogen is <150 mg/dL, or clinically indicated, then PT-fibrinogen will be performed at an additional charge.

If D-dimer is >500 ng/mL FEU, then soluble fibrin monomer will be performed at an additional charge.

If APTT mix is > or =38 seconds and thrombin time is <35.0 seconds (no evidence of heparin), then platelet neutralization procedure will be performed at an additional charge.

If VWF activity assay is <55% or VWF activity:VWF antigen ratio is abnormally increased, then VWF ristocetin cofactor activity assay will be performed at an additional charge.  

If VWF antigen is <55%, the VWF activity is <55%, or the VWF activity:VWF antigen ratio is abnormal, then VWF multimer analysis will be performed at an additional charge.

If appropriate, coagulation factor assays or Staclot LA will be performed at an additional charge to clarify significant abnormalities in the screen test results.

If factor VIII result is <55%, the factor VIII inhibitor screen may be performed along with the Bethesda titering assay, if inhibitor screen is positive.

See Hemophilia Testing Algorithm in Special Instructions.

• Coagulation Guidelines for Specimen Handling and Processing
• Coagulation Patient Information
• Hemophilia Testing Algorithm
• Coagulation Profile Comparison

PTSC, APTSC, TTSC, FXIII, F8A, F_9 IBETH, F8IS, PNP, F5_IS, APSMC, DRV2, DRV3, STACL, DRVI, PTFIB: Optical Clot-Based

RIST: Ristocetin Induced Agglutination of Washed Normal Platelets

VWAG, VWACT, DIMER, SOLFM: Latex Immunoassay (LIA)

CLFIB: Clauss