Quest lab tests for hypercoagulation?

[Guest guest]

Does anyone know what tests Quest might offer that would measure

hypercoagulation? I have read that protime test is NOT a measure of

hypercoagulation (does this mean that ANY 'traditional' test that

measures clotting is not an accurate indicator of hypercoagulation?)

Any suggestions as to a name of a test that I could look up would be

appreciated. Les PS: Would these same tests be used for APS

(AntiPhospholipid Syndrome?)?

[Guest guest]

Why Quest? Hemex labs in Phoenix has led the way in defining the CFS <

-> hypercoagulation connection. For a " poor man's " screen you could

do a sed rate (ESR), which according to Berg, is typically

below 5 in hypercoagulable states. The next test I would think of

would be the " Soluble Fibrin Monomer " (or just " Fibrin Monomer " to

some labs). SFM is probably the best single test because it measures

the actual sticky threads floating in your blood which make it

viscous and clot-prone. Hemex measures SFM as part of their ISAC

panel but they are out of the reagent they need until summer. You

could try Labcorp, who contract out to another specialty lab called

Esoterix. I think Quest can do it as well but it depends on what the

closest regional lab is. I have no idea which lab is more reliable --

I would look into Labcorp/Esoterix since Esoterix specializes in

coagulation just like Hemex.

If there is a hypercoagulable state, the next question would be what

is causing it. There could be immune activation but hereditary

defects are also common. Hemex sells two panels called the ISAC and

HTRP that will give you started. You might need further antibody (e.

g. antiphospholipid antibody) or genetic tests (e.g. Factor V Leiden)

to pinpoint the cause.

Note that the two Hemex panels combinded cost about $1000 (excluding

SFM). They will courtesy bill insurance but you have to pay up front.

Also you need to find a dry ice supplier, and then quickly get a

complicated blood draw done and shipped.

The clotting system is very complicated so unfortunatly a lot of

tests are required to diagnose what is going wrong with it. If I had

just done the ISAC/CFS panel I would have missed the hereditary

defects entirely. I'm not sure what the cost/benefit is yet myself.

The specific tests on the Hemex panels are:

ISAC:

platelet activation by flow

fibrinogen

fragment 1+2

t/at (thrombin/antithrombin) complexes

SFM (available around July)

HTRP:

antithrombin activity

protein C activity

protein S activity

APC resistance

factor II activity

Lp(a) / lipoprotein A

PAI-1 activity

homocysteine

>

> Does anyone know what tests Quest might offer that would measure

> hypercoagulation? I have read that protime test is NOT a measure

of

> hypercoagulation (does this mean that ANY 'traditional' test that

> measures clotting is not an accurate indicator of hypercoagulation?)

> Any suggestions as to a name of a test that I could look up would

be

> appreciated. Les PS: Would these same tests be used for APS

> (AntiPhospholipid Syndrome?)?

>