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All Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML)
SRI SURYO ADIYANTI
Department of Clinical Pathology, Faculty of Medicine, Universitas Indonesia, Jakarta
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience

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CLOT WAVE ANALYSIS IN LIVER CIRRHOSIS WITH NORMAL COAGULATION PROFILES : A PRELIMINARY STUDY YAN MARDIAN; SRI SURYO ADIYANTI
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 3 (2026)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i3.2821

Abstract

Patients with liver cirrhosis are at risk of developing coagulopathy, particularly bleeding complications. Conventional screening tests, such as Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT), measure only clot formation time, offering limited insight into the comprehensive coagulation dynamics. Clot Wave Analysis (CWA), obtained from photo-optical coagulation analyzers, monitors real-time changes in transmitted light during fibrin formation, providing deeper insights into the coagulation process. Although earlier studies demonstrated CWA's utility in detecting coagulopathy in cirrhotic patients, its role in individuals presenting with normal PT and APTT values, or in early-stage cirrhosis, remains insufficiently explored. This preliminary cross-sectional study aimed to evaluate clot waveform characteristics using CWA in cirrhotic patients exhibiting normal coagulation profiles for the early identification of coagulation abnormalities. Waveforms from PT and APTT assays were qualitatively analyzed for patterns and quantitatively assessed using parameters including maximum velocity (Min 1, dT/dt), maximum acceleration (Min 2), maximum deceleration (Max 2, d²T/dt²), and maximum clot density (Delta, dH). This study enrolled 50 participants (25 cirrhotic patients and 25 healthy controls) with normal PT and APTT values. Qualitatively, cirrhotic patients exhibited flatter waveform slopes compared to controls. Quantitatively, significant reductions were observed in Min 1, Max 2, and Delta in CWA-PT and all parameters in CWA-APTT. CWA shows potential in detecting coagulopathy in cirrhotic patients with normal PT and APTT. Further studies are needed to establish standardized CWA reference values for clinical applications.
MEAN PLATELET VOLUME IN TYPE 2 DIABETES MELLITUS WITH CORONARY ARTERY DISEASE Sri Suryo Adiyanti; Veronika Cahya Wijaya
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 3 (2026)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i3.2529

Abstract

Platelets drive atherothrombotic events, causing coronary artery disease (CAD), particularly in individuals with type 2 diabetes mellitus (T2DM). Several studies have reported that T2DM patients exhibit higher mean platelet volume (MPV), which enhances platelet activities. This study aimed to evaluate the mean difference in MPV between T2DM patients with and without CAD. A cross-sectional study was conducted from May 2023 to August 2024 at Dr. Cipto Mangunkusumo Hospital. A total of 230 subjects were divided into two groups: T2DM with CAD and T2DM without CAD. Sysmex XN-3000 was used to measure MPV. Subjects with T2DM and CAD had a higher MPV compared to those without CAD (with CAD=9.9 (8.5-12.3) vs. without CAD=9.6 (7.7–11.4); p=0.001). However, MPV did not differ among subjects with different numbers of vascular disease (1VD=10.1 (8.9–11.9) vs. 2VD=9.7 (9.0–11.3) vs. 3VD=9.9 (8.5–12.3) vs. non-significant=9.7 (9.1–11.4); p=0.930). In conclusion, subjects with T2DM and CAD exhibit higher MPV. Future studies examining the potential of MPV as an alternative risk assessment tool for CAD in T2DM patients might be made feasible by these findings. Mean platelet volume can be obtained from simple, inexpensive, and widely available hematological examinations, and it offers high clinical utility for resource-limited laboratory settings.
ACQUIRED HEMOPHILIA A IN AN ELDERLY FEMALE: A CASE REPORT Sri Suryo Adiyanti; Fidrianie Ramadhona
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 3 (2026)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i3.2596

Abstract

Acquired hemophilia A (AHA) is a blood clotting disorder caused by the formation of specific autoantibodies that can inhibit the action of Factor VIII (FVIII). This case presents a 65-year-old female with a 4-month history of bleeding manifestation, including left subconjunctival hemorrhage, bruising on the right arm, and swelling in the left arm and right knee. Laboratory examination revealed an isolated prolonged activated partial thromboplastin time (aPTT), FVIII activity <1%, and inhibitor FVIII titer 206.4 Bethesda units (BU), with therapeutic management based on hemostatic control with intravenous Eloctate® (rFVIIIFc) and immunosuppressive therapy. The underlying condition associated with the development of AHA was not found in this patient.
Co-Authors Fidrianie Ramadhona Veronika Cahya Wijaya YAN MARDIAN