Qualitative determination of plasma factor VIII inhibitors

The qualitative determination of plasma factor VIII inhibitors is a qualitative determination of plasma factor VIII inhibitors in humans. Factor VIII inhibitors are an antibody, most of which are IgG, and a few are IgG and IgM mixed. Usually, the κ light chain type of IgG is common, and the κ and λ light chain mixed types are also common. Basic Information Specialist classification: growth and development examination classification: blood examination Applicable gender: whether men and women apply fasting: fasting Tips: Do not eat too greasy, high-protein foods the day before, and avoid heavy drinking. Normal value The test result was negative. Clinical significance Abnormal result The test results were positive, ie, the presence of a plasma factor VIII inhibitor, which resulted in a decrease in factor VIIIC activity due to the inactivation of factor VIIIC by the plasma factor VIII inhibitor. The clinical symptoms are similar to those of severe hemophilia A, and the treatment of conventional anti-hemophilic globulin preparations is not effective. Factor VIII inhibitors often occur in 10% to 20% of severe hemophilia A after repeated infusion of blood or plasma products, but also in pregnant women, postpartum, infants, autoimmune diseases, allergic diseases, and DIC. Positive results may be diseases: Chronic granulocyte monocytic leukemia considerations Taboo before the test: Do not eat too greasy, high-protein foods the day before the test, to avoid heavy drinking. The alcohol content in the blood directly affects the test results. After 8 pm on the day before the medical examination, you should fast. Requirements for examination: When taking blood, you should relax your mind to avoid the contraction of blood vessels caused by fear and increase the difficulty of blood collection. Inspection process Vascular blood collection was used for testing. Before venous blood collection, carefully check that the needle is securely installed and that there is air and moisture in the syringe. The needle used should be sharp, smooth, ventilated, and the syringe should not leak. Firstly, the skin was disinfected from the inside to the outside and clockwise from the selected venipuncture with a 30g/L iodine swab. After the iodine was volatilized, the iodized trace was wiped out in the same way with a 75% ethanol swab. Fix the lower end of the venipuncture site with the thumb of the left hand, hold the syringe syringe with the thumb and middle finger of the right hand, and fix the needle lower seat with the index finger, so that the bevel of the needle and the scale of the syringe are upward, and the needle is inclined along the vein to make the needle and the skin obliquely penetrate the skin at an angle of 30°. Then, through the vein wall, enter the venous cavity forward at an angle of 5°. After seeing the blood return, the needle will be probed into the spot to avoid the needle slipping out when the blood is collected; but it is not possible to use a deep puncture to avoid hematoma, and immediately remove the cuff. Needle plug can only be pumped out, can not be pushed in, so as to avoid injecting air into the vein to form a gas plug, causing serious consequences. Remove the syringe needle and slowly inject the blood into the anticoagulation tube along the tube wall to prevent hemolysis and foam. A blood sample was taken to separate the plasma. The test plasma, white clay - cephalin suspension 0.1 ml each, mix, 37 ° C water bath for 3 min, gently shake several times. Add 0.1ml of 0.025mol/L calcium chloride solution, start the stopwatch immediately, shake constantly and observe the time of fibrin wire. Repeat 2 times, take the average and make a normal control. To the test tube, 109 ml/L sodium citrate or 0.1 mol/L sodium oxalate solution 0.2 ml was added, and then 1.8 ml of the test blood was added and mixed, and the plasma was separated by low speed centrifugation. Take 1 small test tube, add 0.1ml of plasma and rabbit brain powder leaching solution, pre-warm at 37 °C, then add 0.1ml CaCl2 solution to pre-warm at 37 °C, immediately start the stopwatch, continuously tilt the test tube, until the liquid flow stops, the time is Prothrombin time. Repeated operation 2 to 3 times, averaged, and served as a normal control. Not suitable for the crowd A patient with hemophilia and severe clotting factor deficiency. Adverse reactions and risks Subcutaneous hemorrhage: subcutaneous hemorrhage due to less than 5 minutes of compression time or blood draw technique.

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