Which laboratory value indicates hemophilia?

When it comes to hemophilia, laboratory tests are essential to confirm its presence and severity. Although there are several lab values that doctors may find useful in diagnosing the condition, some values stand out.

In this article, I’ll break down these key laboratory values with humor and ease – so sit tight, grab your popcorn-slash-fruits-slash-chips (whatever floats your boat), and let’s dive into the world of hemophilia!

Factor VIII Activity Level

The first test doctors usually perform when suspecting a patient has hemophilia is assessing their factor VIII activity levels. But what on earth is factor VIII? you ask.

Well, my dear Watson, factor VIII is a protein that helps blood clotting. Individuals with hemophilia A have low levels of this specific blood-clotting protein due to faulty or missing genes which code for clotting proteins – lovely little thing called genetics!

Doctors determine the quantity of working factor VIII by measuring how long it takes for an individual’s plasma (the liquid part of blood) to form a clot after mixing it with calcium salts and thromboplastin – both coagulation inducers [1].

The results presented as percentages depict whether someone’s performance mimics 100 percent being considered normal while lower amounts indicate less available factors.

If all that sounded like proton science, here’s the bottom line: If one has working (“normal”) FVIII level between about 0-75%, then they’re at risk for excessive bleeding from even minor damage or trauma such as cuts.”

Individuals who fall within these parameters will want frequent medical monitoring beyond routine checkups because creating enough clots during bleed times will be taxing on their limited amount.

Bleeding Time test

Think ’50 shades’ but different! The bleeding time test injects sarcasm-free sadistic pleasure compared to what you thought. This test examines the function of platelets as opposed to blood factors because platelets are formed elements (particulate matter) of your whole blood that bind together over a wound or an injury and form the infamous clot.

This process encompasses 2 stages:

  • initial – where irregular little capillary bleed is induced by pricking with a sterile needle

  • evaluation time – observe how long it would take for this opening made on your body to stop bleeding.

Don’t worry folks, nothing dangerous about this one!

Platelet deficiency is correlated with mild hemophilia disorders called von Willebrand disease; therefore, results indicating extended bleeding times infer that these individuals may be more prone^ to deep cuts and surgical procedures.

Thrombin Generation Test

I swear doctors choose laboratory tests based on their impregn-ability rate in our minds; case and point-Thrombin generation test. But I’ll save you the technical details!

TG assesses overall coagulation status using thrombin which converts fibrinogen into fibrin, causing clots formation [2][3].

Doctors gather information concerning thrombin-generation characteristics like lag-time (initiation), peak height (thrombin concentration attained), total amount generated among other parameters. These values tend to provide insight into pathological alterations in clotting capacity either due to genetic mutations or anticoagulant treatments such as heparin overdose (heh-heh-heparin? Good luck trying not laughing next time you see/hear this term) aimed at preventing unwanted clots production within vessels^ noted Cojocaru et al.,(2017).

We all need some good thigh-slappine humor right now so here goes:

Pro-tip: if someday asked where Charles Dickens derived inspiration from his works sassing “it looks like something outta Bleak House” ain’t too far-fetched! Haha! Get it? OK, I’ll stop.

Other tests

Additional laboratory values that may inform the presence or severity of hemophilia include:

  1. PFA-100 – offers insight into one’s platelet function, given time taken to block a narrow artificial opening diameter pipe filled with collagen and epinephrine.

  2. Mixing Study Test – used in instances where FVIII levels are low when measuring plasma from two different sources: first being that obtained from a healthy individual serving as our control (plasma) while the second has low factor VIII activity (plaintiff’s plasma).

The two plasmas mixed then assessed for clotting tendencies over 2 hours copying what could happen within human body before ‘Memento’ was made. This similarity helps differentiate between whether someone presents with hemophilia A or B^[4].

  1. PT/INR Levels – Laboratory blood test examining prothrombin time which is how long it takes thrombin factors, alpha-factors produced by cells in liver-cells (vitamin-K dependent) triggering process leading to fibrinogin-to-fibrin-conversion hence assisting clots production.^[\5][\6]


In summary, several laboratory values indicate the presence and severity of hemophilia; however,factor VIII activity level remains paramount due to its specific correlation with this disorder.People reporting symptoms should consult their healthcare professional immediately.#So no monkey business!

Hemophilia is a very complex condition but understanding lab results can significantly help in management.Looking at labs alone without clinical correlations doesn’t make sense because,beyond numbers,” each patient brings forth their situation”the facepalm moment weve all experienced so often.

Anyway,cheers! Here’s hoping you won’t fall asleep next time your doctor mentions some labs stuff about ‘Healthy Tony who climbs trees’ sounds oddly relatable though.

[1]: Kasper DL, Fauci A, Hauser S, Longo D, Jameson JL, Loscalzo J. 2021. Harrison’s Principles of Internal Medicine.

[2]: Galt SW et al.(2016) Thrombin generation: a sensitive indicator of hemostatic potential as well as hypercoagulable states.

[3]: Hoffman M (2009). “ABNORMALITIES OF COAGULATION FACTOR FUNCTION” Chapter 107; Clinical Hematology: Theory and Procedures E-Book

[4]: Cretu O., Dhakal P., Rhoads JP (2020) Mixing Study eMedicine Available from:https://emedicine.medscape.com/article/2170046-overview

[\5] Ali-Raja A et al.(2019) Prothrombin time Practice Essentials http://www.emedicinehealth.com/prothrombin_time_test/viewer.htm#proportion_time_definition_and_links_to_our_expanded_content

[\6] Wintrobe MM Smith CA (1948): Clinical Hematology Lea & Febiger Philadelphia

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