Panel Testing

The Hemostasis and Thrombosis Laboratory recognizes that the approach to coagulation testing can be complicated. For convenience, therefore, we recommend groups of tests (panels) for the following specific indications:

Easy bruising and/or bleeding

Initial testing:
Complete Blood Count and Platelet Count (performed at Florida Hospital Orlando Hematology Department)
Platelet Function Analyzer (PFA)-100 test
Prothrombin Time
Activated Partial Thromboplastin Time
Factor XIII screening test

Possible follow-up and/or reflexive testing:
Platelet Aggregation study
Mixing Studies
Thrombin Time
Reptilase Time
Fibrinogen Assay
Evaluation for von Willebrand's Disease (see below)

Von Willebrand's Disease

Initial testing:
Platelet Function Analyzer (PFA)-100 test
Activated Partial Thromboplastin Time
Factor VIII activity
Von Willebrand Factor Activity
Von Willebrand Factor Antigen

Possible follow-up and/or reflexive testing:
Ristocetin-Induced Platelet Aggregation
Von Willebrand Factor Multimers

Lupus Anticoagulant / Antiphospholipid Syndrome

Initial testing:
LA-sensitive APTT (PTT-LA)
LA Ratio (DRVVT)
Kaolin Clot Time (KCT)
Anticardiolipin Antibodies
Antiphosphatidylserine Antibodies
Antibeta2-glycoprotein I

Possible follow-up and/or reflexive testing:
Mixing studies on PTT-LA, DRVVT or KCT as appropriate
Hexagonal Phase Phospholipid (Staclot-LA) test

Hypercoagulable State

Initial testing:
LA-sensitive APTT (PTT-LA)
Antithrombin Activity
Protein C Activity
Protein S Activity
Activated Protein C Resistance Ratio or Factor V Leiden PCR test
Prothrombin 20210 Gene Mutation
Plasma Homocysteine  (performed at Florida Hospital Orlando Chemistry Department)

Possible follow-up and/or reflexive testing:
Further tests for Lupus Anticoagulant and/or Antiphospholipid Syndrome
Protein C Antigen
Protein S Antigen (free and total)
Factor VII (if Protein C <40%). Normal FVII assay excludes liver disease and Vitamin K absence or antagonism as a cause of decreased Protein C.
Factor VIII (if Protein S <40%). Normal FVIII assay excludes acute phase reactions as a cause of decreased Protein S.
Methylenetetrahydrafolate Reductase (MTHFR) Gene Mutation for unexplained elevation of plasma homocysteine.