Summary
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Haemostasis
Enormous progress has been made in our understanding of haemorrhagic diseases, which often leads to an earlier and more precise diagnosis, and to an improvement in therapeutic management.
The high incidence of deep vein thrombosis, which can be life-threatening, underlines the importance of investigating the risk factors of thrombosis and the underlying clinical and biological aetiology.
Eurofins Biomnis has acquired considerable expertise in the field of haemostasis, and offers a complete selection of laboratory tests specialized in this area:
- for the diagnosis of haemorrhagic diseases (assays on coagulation factors…), to support studies on fibrinolysis, and for the detection of anti-factor VIII;
- for the diagnosis of acquired or constitutional thrombophilias (assays on the physiological coagulation inhibitors antithrombin, proteins C and S, resistance to activated protein C, the Lupus anticoagulant, anticardiolipin antibodies, anti-beta 2 glycoprotein 1, homocysteine…), of mutations in factor V Leiden and the prothrombin G>A20210 mutation;
- to monitor treatments with heparins, fondaparinux (Arixtra®), danaparoid (Orgaran®), and the direct oral anticoagulants (DOACs) dabigatran (Pradaxa®), rivaroxaban (Xarelto®) and apixaban (Eliquis®);
- to assist with the diagnosis of type 2 heparin-induced thrombocytopenia (HIT);
- to exclude venous thromboembolic diseases and other related diagnoses (D-dimer assays).
These tests are performed using chronometric, chromogenic, immunological, and molecular biology protocols.
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Haemoglobinopathies
The first approach is capillary electrophoresis of haemoglobin. If a haemoglobin variant is detected, two other techniques are used to identify this variant: HPLC and acid gel electrophoresis. Eurofins Biomnis collaborates with research groups on haemoglobinopathies at Lyon Hospital to identify rare phenotypic variants of haemoglobin and to investigate the globin genes.
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Immunohaematology
The following analyses are performed at Eurofins Biomnis:
- blood typing ABO-RH-KEL1, extended phenotyping (systems FY, JK, MNS, LE, LU, etc.),
- screening and identification of red cell antibodies,
- the direct antiglobulin test,
- titration and microtitration of anti-RH1 antibodies for the screening of a potential anti-RH1 immunisation in pregnant women after they received an injection of anti-D gamma globulins. Eurofins Biomnis collaborates with the CNRHP (Centre National de Référence en Hémobiologie Périnatale; National Centre of Reference in Perinatal Haemobiology) to monitor alloimmunised patients (titration, weighted assays for antibodies), and with the INTS (Institut National de la Transfusion Sanguine; National Institute of Blood Transfusion) for the diagnosis and monitoring of anti-platelet alloimmunizations.
- research and quantification of fetal-maternal haemorrhage by flow cytometry. This technique is more reliable than the Kleihauer test and it measures with precision the percentage of fetal erythrocytes in the maternal circulation.
Resources
Haemostasis
Focus 49 – VKA
Focus 47 – Thienopyridines
Focus 37 – Clinical Cases of Haemostasis
Focus 36 – Myeloma haemostasis
Focus 26 – ACC
Focus 25 – aPTT
Focus 20 – Haemophily A
Focus 19 – Factor VIII
Focus 6 – Antiphospholipid Syndrom
