Bloody Minded Episode 8 - In the Lab: The Bethesda Assay
Jul 2, 2024
Dive into the fascinating world of the Bethesda Assay, a crucial test for hemophilia that has baffled trainees for years. Discover how this assay measures factor inhibitors and learn about its significant modifications to enhance accuracy. The discussion also navigates the complexities of coagulation testing in diverse patient conditions, shedding light on the nuances of factor VIII inhibitors. With a playful blend of education and personal anecdotes, this conversation equips listeners with insights essential for mastering this challenging aspect of hematology.
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Purpose of Bethesda Assay
- The Bethesda Assay quantifies the strength of factor inhibitors, crucial for managing hemophilia treatment.
- It emerged to measure inhibitors that neutralize clotting factors, especially Factor VIII antibodies.
How Bethesda Assay Works
- To measure inhibitors, mix patient plasma (containing inhibitor) with pooled normal plasma (containing factor).
- Incubate for two hours at 37°C before measuring factor levels to determine inhibitor activity.
Nijmegen Modification Enhances Sensitivity
- Nijmegen modification improves assay accuracy using factor-deficient plasma instead of buffer.
- This adjustment reduces pH and protein changes that can falsely affect factor stability and inhibitor measurement.