The Use of Ethanol Gelation Test to Screen the Activation of Coagulation and Disseminated Intravascular Coagulation / 임상검사와정도관리

ABSTRACT

BACKGROUND: Ethanol gelation test (EGT) is one of the paracoagulation test used to detect the activation of coagulation and formation of fibrin monomer complexes in the fibrinolytic process. Many patients with infectious diseases such as dengue haemorrhagic fever can develop disseminated intravacular coagulation (DIC), which should be diagnosed properly as soon as possible for the management of the patients. To diagnose the coagulation activation and DIC usually the laboratory has to perform the coagulation test, including fibrinopeptide A and D-dimer test. Many laboratories in rural areas in Indonesia do not have the facilities to do such test, and the cost will not be affordable by most of the patients. The aim for the study is to evaluate the EGT as a screening test to detect coagulation activation and DIC, the correlation of D-dimer and EGT. Method: Sixty citrated plasma were obtained from patients in Clinical Pathology Laboratory Cipto Mangunkusumo Hospital for D-dimer test. D-dimer were performed using Nycard Kit with cut off point of 300 ng/dl. The EGT were performed using the method described by Breen. Positive test could be observed by the clot formation. RESULTS: The result of the within-run test for normal and abnormal plasma for EGT showed good results. The plasma was stalell until day 22. The EGT was positive for all the plasma with D-dimer >700 ng/ml. The sensitivity for EGT was 81.6%, specificity 81.8%, positive predictive value 95.2% and negative predictive value 50%. Conclusion: EGT could be used as a screening test for thrombin activity in coagulation activation in rural laboratories with minimal facilities.