Laboratory testing for LA
Laboratory testing for LA
Laboratory testing for LA
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
<strong>Laboratory</strong> <strong>testing</strong> <strong>for</strong> <strong>LA</strong> –<br />
To mix or not to mix – that is the question!:<br />
‣ Not mixing can lead to false negative <strong>LA</strong> in some cases of strong <strong>LA</strong>.<br />
‣ Case 1: ‘diagnostic challenge’<br />
‣ Very strong <strong>LA</strong>, dispatched to 93 RCPA QAP participants<br />
‣ Participants were blind to presence of <strong>LA</strong> and asked to per<strong>for</strong>m ‘usual <strong>testing</strong> as<br />
if this sample was received <strong>for</strong> a specific patient investigation’.<br />
‣ Clinical in<strong>for</strong>mation provided:<br />
‣ Sample referred from a satellite facility<br />
‣ 76 year old female patient, B-cell lymphoma diagnosed 4years ago<br />
‣ Put on 3-month follow-up with no specific therapy.<br />
‣ During recent follow-up visit identified to have increasing abdominal distension, night<br />
sweats, weight loss and a significant drop in haemoglobin.<br />
‣ Further clinical investigation might require exploratory surgery.<br />
‣ Routine coagulation tests per<strong>for</strong>med at satellite facility showed prolongation of both<br />
prothrombin time (PT) and activated partial thromboplastin time (APTT). Mixing tests did<br />
not show any substantial correction.<br />
‣ Satellite facility is otherwise unable to provide any additional in<strong>for</strong>mation<br />
Favaloro et al. JTH 2010; 8: 2828–31.<br />
Bonar et al. Pathology 2012;44:240–7<br />
25
Change language