Electron microscopy aids in diagnosing unexplained bleeding

Norton Healthcare’s Special Coagulation Laboratory offers sophisticated testing for patients who present with unexplained bleeding. Among the tests available is electron microscopy to assess the number of dense granules in platelets. A lack of dense granules can indicate a rare disorder called delta storage pool deficiency.

“If you have a paucity of dense granules, you don’t clot as efficiently,” said Jessica Hata, M.D., pediatric and renal pathologist. “Electron microscopy is considered the gold standard test to diagnose this deficiency.”

Norton Healthcare invested in a state-of-the-art transmission electron microscope three years ago. Having an electron microscope in house allows for a much faster diagnosis because blood samples do not have to be sent out.

Unexplained bleeding can manifest as recurrent nosebleeds, excessive menstrual bleeding and unexpected bleeding during surgery, Dr. Hata said. In cases of suspected child abuse, bleeding disorders need to be ruled out, she added.

“It’s important to know what the coagulation status of a patient is,” said Elpidio Pena, M.D., medical director, Transfusion Services and Special Coagulation Laboratory.

The Special Coagulation Laboratory also checks for inherited bleeding disorders, such as Von Willebrand
disease, and performs tests that would show if a patient is at risk for thrombosis or has an unexplained clot.

“A person with an unexplained clot or bleeding needs to be tested. We need to know why this happened,” Dr. Pena said.

For more information on electron microscopy or the Special Coagulation Laboratory, contact Dr. Pena at elpidio.pena@nortonhealthcare.org.

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