Bloody Minded Episode 9 - Snakes on the (Laboratory) Brain | Venoms in the Coagulation Lab with Kent Chapman
Jul 9, 2024
Dive into the captivating world of snake venom and its unexpected role in laboratory hematology. Discover how snake venoms, like those from the Russell Viper, are used in critical coagulation tests. Learn about the fascinating assays such as dilute Russell Viper Venom Time and the clinical implications of venom components for diagnosing clotting disorders. Gain insights into the challenges posed by innovative anticoagulants and the significance of expert collaboration in ensuring accurate laboratory testing.
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DRVVT in Lupus Testing
- Dilute Russell Viper Venom Time (DRVVT) is critical for lupus anticoagulant testing, targeting factor 10, 5, and 2 in the clotting cascade.
- It uses two reagents with varying phospholipid levels to detect and confirm phospholipid-dependent clotting abnormalities.
Manage DOAC Interference
- Always inform the lab about patient medications, especially DOACs, to avoid misinterpretation of coagulation tests.
- Use DOACSTOP, an activated charcoal product, to remove DOAC interference for accurate lupus anticoagulant testing.
Warfarin's Impact on Lupus Testing
- Warfarin acts like a factor deficiency affecting factor 10, but mixing tests can usually allow meaningful lupus anticoagulant detection.
- Lupus anticoagulants can still be detected reliably at therapeutic INR levels using mixing techniques.