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Acquired coagulation disorders 

Acquired coagulation disorders
Chapter:
Acquired coagulation disorders
Author(s):

T.E. Warkentin

DOI:
10.1093/med/9780199204854.003.220605_update_001

Update:

Updated information on frozen plasma, the urgent reversal of coumarin anticoagulation, the withdrawal of Drotrecogin alfa, new oral anticoagulant overanticoagulation, and the treatment of heparin-induced thrombocytopenia (HIT).

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date: 04 December 2020

Acquired disorders of coagulation may be the consequence of many underlying conditions, and although they may share abnormality of a coagulation test, e.g. a prolonged prothrombin time, their clinical effects are diverse and often opposing.

Diagnosis—most acquired disorders of coagulation can be identified by screening haemostasis tests, including (1) prothrombin time (PT); (2) activated partial prothromboplastin time (aPTT); (3) thrombin clotting time (TCT); (4) fibrinogen degradation products (FDPs); (5) the cross-linked fibrin assay (D-dimer); (6) protamine sulphate paracoagulation assay; (7) bleeding time—now rarely required or performed; and (8) complete blood count with examination of a blood film. Few bleeding disorders give normal results in all these tests, but disorders predisposed to thrombosis as a result of deficiency of natural anticoagulants (e.g. antithrombin III, protein C, protein S) must be specifically sought....

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