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Pediatric Hematology/Oncology • Internal Medicine • Hematology • Pediatric Hematology • Benign Hematology • Hemostasis/Thrombosis • Pulmonology • Critical Care
Do you use FVIII levels to differentiate between DIC and coagulopathy of liver disease?
Common thought is that FVIII may be used for differentiating coagulopathy in liver disease (normal to increased, from reduced clearance of VWF/FVIII) from DIC (reduced, from consumption).
However, the counterpoint is that as an acute phase reactant, FVIII may be increased in DIC.
There are some older trials, demonstrating both these contradictory findings (Corrigan Jr. et al., PMID 4758284 vs. Spero et al., PMID 6773170). If baseline levels of FVIII are known, that may be helpful to establish a change.
Do you use FVIII levels for this indication in your clinical practice?
Answer from: at Academic Institution
DIC is a clinical diagnosis that is difficult to establish in the absence of bleeding or thrombosis, particularly in patients with liver disease. I do think that following DIC laboratory markers (FDP, fibrinogen, D-dimer) serially may be helpful as you would not expect them to acutely drop simply be...
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Answer from: at Community Practice
I personally teach to check FV and FVIII and a Vit K dependent factor, although the protime is a good approximation of FVII in most cases, when a diagnosis of Liver dysfunction, DIC, and Vit K deficiency are all possible or there may be more than one phenomenon at play.Factor V was referred to as &l...
Comments
Medical Oncologist at Locum Tenens
I am going to officially borrow the "poor man's li...
I am going to officially borrow the "poor man's li...
at FibroFighters Foundation
From my mentor, Dr. Gerald Gilchrist (Mayo), who p...
From my mentor, Dr. Gerald Gilchrist (Mayo), who p...
Answer from: at Academic Institution
Yes, but only in the context of the many other parameters that one measures in working up these patients.
Answer from: at Community Practice
Factor VIII is an acute phase reactant and is often elevated in liver disease. It is not a reliable marker in this setting.