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Quick Guide to Coagulation Testing. Marisa B. Marques and George A. Fritsma, Washington, DC: AACC Press, 2006, 62 pp., $15 ($12 AACC members), softcover. ISBN 1-59425-049-9.

University of Colorado Health, Sciences Center and Denver Health, Medical Center, Denver, CO 80204

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In the past decades, significant advances have been made in understanding coagulation disorders, including thrombophilias and bleeding diatheses. Anticoagulant therapy has advanced just as rapidly, leading to the development of several new classes of drugs that may be used to treat those coagulation disorders. Our theoretical understanding of coagulopathies has been paralleled by analytical developments to help establish accurate clinical diagnoses and to aid monitoring of new therapeutic interventions.

Clinical practitioners have recognized these coagulopathies and have been administering the new anticoagulants, thus driving the need for more complex coagulation testing in clinical laboratories. Unfortunately, the clinicians’ understanding of selection and interpretation of the appropriate coagulation tests has not progressed as rapidly. The principal reason may be that diverse coagulation disorders present with only a limited number of apparently similar clinical symptoms. Often the exact diagnosis can be elucidated by test panels only, or by sequential application of multiple tests during which each subsequent test is selected based on results of the preceding analyses. The presence or absence of comorbid conditions, such as an acute illness, pregnancy, or the treatment of a coagulation disorder before the final diagnosis is established, can interfere with results of coagulation testing to the extent that correct diagnosis . . . [Full Text of this Article]