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LABORATORY  DIAGNOSIS  of  the HYPERCOAGULABLE  STATE - 2000

  1. The coagulation System: Vessels, Platelets, Cascade, Natural Inhibitors of the Cascade, Fibrinolysis and Blood Flow.

    2.  
  2. Hypercoagulability

    3.  
    1. Vessels:   Homocysteine ,  vWF Antigen :  Inflammation,  fibrinolysis
    2. Platelet Function: Hypo or Hyperactivity : Platelet Activation Cause of Hyper Platelets: Stenosis &/or GP IIIa polymorphism
    3. Increased Cascade:   Fibrinogen,  II,  VIII,  IX,  X,  XI,  XII, Dysfibrinogenemia, Prothrombin Gene Mutation 20120
    4. Decreased Natural Inhibitors: Proteins C, S, AT
    5. Decreased Fibrinolysis:   tPA,  PAI-1,  Plasminogen,  Lp(a)
    6. Resistance of factor V to inactivation by Protein C:

      7. Positive APC Resistance Test (Arg506, Arg306, or Arg679 mutation)
      Factor V Leiden (Arg506 right arrow Gln506) &/or Factor V R2 polymorphism
  3. Acquired Inhibitors

    4.  
    1. Dialyzable Inhibitor
    2. AntiPhospholipid Antibody Syndrome - APS
      1. Lupus Anticoagulant - LA
      2. AntiCardiolipin Antibody - aCL
      3. AntiPhosphatidylserine Antibody - aPS
      4. Anti-B 2 GPI Antibodies
      5. Anti-Annexin V Antibody
  4. Risk Assessment

    5.  
    1. I mmune S ystem A ctivation of C oagulation - ISAC Panel
    2. Hereditary Risk Panel: PC, PS, AT, APC Res, F II, Lp(a), Homocysteine
    3. Soluble Fibrin Monomer - SFM - Quantitative
    4. Anti-B 2 GPI Antibodies
    5. PA - Platelet Activation by Aggregation or Flow Cytometry
  5. Markers of Cascade & Hemostasis Activation  - MOCHAs

    6.  
    1. Fibrinogen
    2. Prothrombin Fragment 1+2
    3. or  Thrombin / Antithrombin Complexes - T/ATs
    4. Soluble Fibrin Monomer - SFM
    5. D-Dimer - Quantitative method

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