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Ordered Items: Coagulation Factor Panel; von Willebrand Disease Profile; Antiphospholipid Antibody Panel
Clinical Indication: Follow-up evaluation for hemarthrosis (bleeding into joint) discovered 01/04/2026. Expanded coagulation workup including vWF assessment.
Coagulation Factor Panel
Measures activity levels of specific clotting factors and general coagulation pathway function to evaluate bleeding and clotting disorders.
Factor VIII
137%
Ref: 57-163%
Factor IX
91%
Ref: 60-177%
Factor XI
90%
Ref: 60-150%
Fibrinogen
226
mg/dL (Ref: 160-420)
| Test |
Result |
Flag |
Units |
Reference Interval |
| Factor VIII Activity |
137 |
Normal |
% |
57-163 |
| Factor IX Activity |
91 |
Normal |
% |
60-177 |
| Factor XI Activity |
90 |
Normal |
% |
60-150 |
| Fibrinogen Activity |
226 |
Normal |
mg/dL |
160-420 |
| APTT |
28.2 |
Normal |
sec |
22.9-30.2 |
| Prothrombin Time |
10.8 |
Normal |
sec |
9.1-12.0 |
| INR |
1.0 |
Normal |
ratio |
0.9-1.2 |
| D-Dimer, Quantitative |
0.37 |
Normal |
ug/mL FEU |
<0.50 |
Interpretation: All coagulation factors and screening tests are within normal limits. Factor VIII, IX, and XI activity levels are adequate, ruling out hemophilia A, hemophilia B, and Factor XI deficiency. Normal PT/INR and APTT confirm intact extrinsic and intrinsic coagulation pathways. Normal D-Dimer indicates no active thrombus formation.
von Willebrand Disease (vWD) Assessment
von Willebrand Factor (vWF) is essential for platelet adhesion and carries Factor VIII in blood. Deficiency causes the most common inherited bleeding disorder.
| Test |
Result |
Flag |
Units |
Reference Interval |
| Factor VIII Activity |
147 |
HIGH |
% |
56-140 |
| vWF Antigen |
143 |
Normal |
% |
50-200 |
| vWF Activity |
126 |
Normal |
% |
50-200 |
Clinical Assessment
Factor VIII Activity Elevated: 147% (ref 56-140%)
Not consistent with von Willebrand Disease.
vWF Antigen and vWF Activity are within normal limits, indicating adequate von Willebrand Factor production and function. The vWF Activity/Antigen ratio is normal, ruling out Type 2 vWD subtypes.
Key Points:
- Elevated Factor VIII (147%): Persistently elevated Factor VIII is an independent risk factor for venous thromboembolism (VTE). This is notable given the patient's hemarthrosis history.
- Note on Factor VIII discrepancy: Two Factor VIII values were obtained — 137% (coagulation panel, ref 57-163%) and 147% (vWF panel, ref 56-140%). The difference reflects different assay methodologies and reference ranges used by different performing laboratories.
- vWF Activity/Antigen Ratio: 126/143 = 0.88 (Normal >0.7). A ratio <0.7 would suggest Type 2 vWD.
Antiphospholipid Antibody Panel (Repeat)
Repeat testing for antiphospholipid syndrome (APS). Initial panel on 01/16/2026 was negative. Repeat testing is recommended to confirm results, as APS diagnosis requires positive results on two occasions at least 12 weeks apart.
| Test |
Result |
Flag |
Units |
Reference Interval |
| Anticardiolipin Ab, IgG, Qn |
<9 |
Negative |
GPL U/mL |
0-14 (Negative <15) |
| Anticardiolipin Ab, IgM, Qn |
<9 |
Negative |
MPL U/mL |
0-12 (Negative <13) |
| Anticardiolipin Ab, IgA, Qn |
<9 |
Negative |
APL U/mL |
0-11 (Negative <12) |
| Beta-2 Glycoprotein I Ab, IgG |
<9 |
Negative |
GPI IgG units |
0-20 |
| Beta-2 Glycoprotein I Ab, IgA |
<9 |
Negative |
GPI IgA units |
0-25 |
| Beta-2 Glycoprotein I Ab, IgM |
<9 |
Negative |
GPI IgM units |
0-32 |
Interpretation: All six antiphospholipid antibodies remain negative on repeat testing (initial testing 01/16/2026 also negative). This effectively rules out antiphospholipid syndrome (APS) as a cause of the hemarthrosis.
Overall Summary:
Ruled Out:
- von Willebrand Disease — normal vWF Antigen and Activity
- Hemophilia A, B, and Factor XI Deficiency — normal factor levels
- Antiphospholipid Syndrome — negative on two occasions (01/16 and 02/24)
- Active thrombosis — normal D-Dimer
- Coagulation pathway dysfunction — normal PT/INR and APTT
Notable Finding:
- Elevated Factor VIII Activity (147%) — an independent risk factor for venous thromboembolism. While this does not explain the hemarthrosis, it is clinically relevant for VTE risk assessment. The cause of the hemarthrosis remains undetermined; may require further hematology evaluation.
Patient Details
Bishop, Tyler
3434 VOYAGER CIR, SAN DIEGO, CA, 92130
Phone: 636-448-1747
DOB: 05/26/1987 | Age: 38 | Sex: Male
Patient ID: BT762792
Physician Details
B VEST
Dermatology Center of La Jolla
6605 Nancy Ridge Dr, San Diego, CA, 92121
Phone: 858-454-7123
Account Number: 04125132
NPI: 1891311403
Specimen Details
Specimen ID: 055-494-8400-0
Control ID: 260414VM
Date Collected: 02/24/2026 1414 Local
Date Received: 02/24/2026
Date Reported: 03/03/2026 0449 ET
Performing Labs:
01: Esoterix Inc, 8490 Upland Drive Ste 100, Englewood, CO 80112-7116 (Factor VIII/IX/XI, Fibrinogen, vWF Panel)
02: Labcorp Phoenix, 5005 S 40th Street Ste 1200, Phoenix, AZ 85040-2969 (Anticardiolipin/Beta-2 GP)
03: Labcorp Clinical/Digital, 2200 Leyland Way, Burlington, NC 27215-9957 (APTT, PT, INR, D-Dimer)
For inquiries: 800-859-6046 | Lab: 858-668-3700