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Maria Stella Graziani

Deputy Director
Martina Zaninotto

Associate Editors
Ferruccio Ceriotti
Davide Giavarina
Bruna Lo Sasso
Giampaolo Merlini
Martina Montagnana
Andrea Mosca
Paola Pezzati
Rossella Tomaiuolo
Matteo Vidali

EIC Assistant
Francesco Busardò

International Advisory Board Khosrow Adeli Canada
Sergio Bernardini Italy
Marcello Ciaccio Italy
Eleftherios Diamandis Canada
Philippe Gillery France
Kjell Grankvist Sweden
Hans Jacobs The Netherlands
Eric Kilpatrick UK
Magdalena Krintus Poland
Giuseppe Lippi Italy
Mario Plebani Italy
Sverre Sandberg Norway
Ana-Maria Simundic Croatia
Tommaso Trenti Italy
Cas Weykamp The Netherlands
Maria Willrich USA
Paul Yip Canada

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Via L. Temolo 4, 20126 Milano

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Giuseppe Agosta

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Chiara Riva
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ISSN print: 0393 – 0564
ISSN digital: 0392- 7091

BC: Articoli scritti da D. Fineschi

Ruolo del laboratorio nella valutazione di un donatore di organi con sospetta emofilia A
Role of the laboratory in the evaluation of an organ donor with reported haemophilia A
<p>The case concerns a 82-year-old patient, organ donor, affected by diabetes mellitus, hypertension and reported type A haemophilia, showing a traumatic severe cerebral haemorrhage. The Medical Committee started the donor evaluation process: the liver was compatible for a recipient in life-threatening conditions. Although the first level coagulation tests were within the normal range, the Regional Center for Organ and Tissue Allocation of the Tuscany Region - Italy requested further investigations in order to clarify the reported diagnosis of haemophilia and to exclude the presence of a specific FVIII inhibitor. FVII activity was evaluated to assess the protein synthesis of the liver, and FVIII for suspected haemophilia; both of them were normal. Considering the importance of the diagnosis, the parallelisms of both FVII and FVIII were performed; the tests were negative for the presence of inhibitors. Second-level tests therefore rejected the diagnosis of haemophilia and excluded the presence of a specific inhibitor of FVIII. The absence of coagulative alterations allowed the liver explant, which was successfully transplanted on a 59-year-old male recipient.</p>
Biochimica Clinica ; 42(3) e37-e39
Casi clinici - Case report
Management of an elderly male patient with subconjunctival bleeding associated with pemphigus in the emergency department
<p>A 82-year-old man suffering from pemphigus and Parkinson&rsquo;s disease presented at the emergency department of the Misericordia Hospital in Grosseto (Tuscany, Italy) with subconjunctival bleeding. Laboratory blood tests showed a prolonged activated thromboplastin time (aPTT), with normal prothrombin time (PT) and slightly reduced haemoglobin. The negative family and personal history of haemorrhagic disease rose the suspicion of the presence of an acquired inhibitor. The patient was referred for further diagnostics to the University Hospital of Siena where second level tests were performed at the Coagulation Unit. The aPTT mixture test revealed a non-correction both at room temperature and, more markedly, after incubation at 37&deg;C for 2h, confirming the presence of an intrinsic pathway inhibitor. Among the measured factors, only the activity level of factor VIII was extremely low. The titration of FVIII inhibitor confirmed the diagnosis of Acquired Haemophilia A (AHA).&nbsp;</p>
Biochimica Clinica ; 17(1)
Casi Clinici - Case Report