Bloody Minded Episode 71 - Clotting For Good | In The Lab: Thrombophilia Testing II
Dec 2, 2025
In this enlightening discussion, the hosts dive into activated protein C resistance testing, exploring its role in diagnosing thrombophilia. They tackle the complexities of Factor V Leiden and the impact of prothrombin gene mutations, emphasizing the significance of molecular testing methods. Alongside their scientific revelations, the crew adds a sprinkle of humor with pop culture references, making for an engaging and informative session. They also warn against ordering MTHFR testing for thrombophilia, highlighting key insights in lab practices.
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Don't Order MTHFR For Thrombophilia
- Avoid ordering MTHFR testing for thrombophilia screening; it's not recommended.
- Dispose of unnecessary MTHFR requests and follow RCPA guidance instead.
APCR Is Not Definitive For FVL
- APCR most commonly reflects Factor V Leiden but other causes can produce resistance.
- A positive APCR requires further testing before concluding a Factor V Leiden mutation.
How Clot-Based APCR Works
- Clot-based APCR compares APTT with and without activated protein C to assess anticoagulant function.
- Normal prolongation with APC indicates intact protein C activity; lack of prolongation indicates resistance or deficiency.