About Paul Charest Expertise Any questions that have to do with hematology. Explaining laboratory tests including :coagulation (PT/aPTT), CBC, differential, ESR, and flow cytometry (leukemia/lymphoma)also including the theory behind them. Hemoglobinopathies, leukemia, lymphoma, hemostasis, hematopoiesis, and cellular morphology are a few of the topics that I teach and practice.
I also have experience with immunohematology, otherwise known as blood banking. Feel free to ask about blood types, blood groups, the type and crossmatch, transfusions, antibody identification, DAT, elutions as well as absorptions
I have also worked in a parasitology lab, as well as taught the subject as well. So feel free to ask about helminths (cestodes, trematodes, and nematodes), protozoan parasites, sporozoan etc.
Lastly, I teach a course in clinical mycology where we grow and identify yeasts and moulds.
Experience I have worked in a hematology lab, flow-cytometry lab, blood bank, and microbiology lab. I am also an instructor at Northeastern University part-time
Expert: Paul Charest Date: 6/28/2008 Subject: antithrombin deficiency and heavy periods?
Question My Antithrombin level is 58 (low) but I have very heavy periods ( and a ferritin level of 5 to prove it )and always bleed very heavily after childbirth. Isnt this a contradiction? Do you think I should have the test repeated ?
Answer Hello Cyndi,
That is probably the most common reaction, your not alone, it is actually common practice to have the lab retest over and over and over again. I guess the MDs take the best of three or something. Since I work in a laboratory, I would love to say that mistakes are never made--but of course that would be a lie. Results can be fudged from the moment the specimen is drawn (mislabelled, drawn into the wrong tube etc.), to the way the specimen was prepared (wasn't spun in the centrifuge at the proper speed), to the way the test was performed. I can't comment on how reputable the lab is that performed your test because I don't know anything about it. But what I do know, is that the people that are performing the tests are tested and quizzed. We process specimens 3 times a day to check the intergrity of our analyzers and our methods. We are sent proficiency tests from many different places and there are procedures for everything. Most of the people that work in these labs have been here for decades.
I'm not sure if you were looking for a lecture on antithrombin III, so I'll spare you for now--but if you want to know more about it, just ask. Anyway, there are two types of inherited antithrombin III abnormalities--the first is a quantitative, meaning that you have decreased levels of ATIII. The second is qualatative, which means that you could have normal or decreased amounts, but it doesn't work (which is intended to inactivate thrombin--an essential player in the coagulation cascade). There are also acquired ATIII problems as well. You can have decreased levels from kidney damage, where you pee out all your ATIII. You can also have a problem with your liver, which will inhibit synthesis of ATIII, which takes place in the liver. ATIII deficiency usually comes to light following a thrombosis, or some kind of hypercoagulable state. You would think that a deficiency of ATIII would give you super clotting powers, and you know for a fact that this is not true because of your low ferritin, heave menstrual bleeding and such. Coagulation is much more complex and there are a bonanza of reasons for your heavy bleeding that has nothing to do with your ATIII levels. Did your MD tell you why you have a decreased ATIII level--whether genetic or acquired. If you had decreased synthesis of the liver, you would have decreased levels of not only ATIII but of most all clotting factors. If you are losing ATIII from kidney damage, you would also be losing all your clotting factors too--which would also explain your heavy bleeding. Perhaps you have a combination of hereditary ATIII deficiency and another coagulopathy such as a specific factor deficiency or VonWillebrands disease. You may need to see a hematologist, someone who specializes in this stuff--that's about the best advice that I can offer from my computer screen.
Sorry for the delay, I have been having some serious family issues and I'm going through a divorce---life hasn't been easy. Thanks for your patience.
