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Jill Lynema ACF Abstract FY12

"Alteplase: Coagulation Testing Nightmare"

American Society for Clinical Laboratory Science (ASCLS) Michigan 2012 Annual Meeting Program

Out with the old and in with the new and improved seems to be the way of life. This has become true also for the treatment of Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE), but it has not come without any problems. A new recombinant tissue plasminogen activator known as Alteplase is making its appearance in DVT and PE treatment due to its rapid onset and short half-life. But, Alteplase brings havoc into the laboratory. The usual D-Dimer testing for monitoring DVT does not look the same as with the previous clot busting drugs used. This case study looks into a particular case of DVT in which unusual D-Dimer tests were seen in the laboratory. An in-depth study of the difference in the results of the different clot busting drugs used and how the laboratory should handle and report the results was investigated.