Euglobulin Clot Lysis Time
Euglobulin Clot Lysis Time (ECLT)
The Euglobulin Clot Lysis Time (ECLT) is a sophisticated laboratory test designed to comprehensively assess the fibrinolytic system's functionality, providing critical insights into the body's clot dissolution mechanisms.
Fundamental Significance
- Gold standard for global fibrinolytic capacity assessment
- Unique ability to measure the intricate balance between fibrinolytic activators and inhibitors
- Essential diagnostic tool for identifying complex fibrinolytic disorders
- Crucial in monitoring and understanding antifibrinolytic therapeutic responses
Historical Context
Developed in the mid-20th century, the ECLT has evolved from a rudimentary technique to a precision diagnostic method, reflecting advances in molecular hematology and laboratory science.
Scientific Principles of ECLT
Biochemical Foundations
- Euglobulin Fraction Isolation:
- Selective precipitation of specific plasma proteins
- Removal of fibrinolysis inhibitors
- Concentration of fibrinolytic factors
- Molecular Components Analyzed:
- Tissue Plasminogen Activator (tPA)
- Plasminogen
- Plasminogen Activators
- Fibrinogen
- Plasmin
Physiological Mechanism
The test exploits the natural process of clot dissolution by isolating and measuring the active fibrinolytic components, providing a window into the body's clot breakdown capabilities.
Detailed Methodology
Sample Preparation
- Requires high-quality citrated plasma
- Critical temperature control (2-8°C)
- Minimal processing delay
- Fasting sample preferred for optimal results
Comprehensive Test Procedure
- Precipitation Phase:
- Precise plasma dilution with acetic acid
- Careful pH adjustment
- Centrifugation to isolate euglobulin fraction
- Clot Formation:
- Precipitate resuspension in buffer
- Controlled thrombin addition
- Formation of standardized clot
- Lysis Observation:
- Continuous clot monitoring
- Precise time-to-dissolution measurement
- Controlled temperature environment
Clinical Applications
Primary Diagnostic Indications
- Suspected hyperfibrinolysis conditions
- Unexplained bleeding tendencies
- Monitoring antifibrinolytic therapeutic interventions
- Pre-operative risk assessment
- Research investigations
Specific Pediatric Contexts
- Congenital fibrinolytic disorders
- Post-surgical bleeding evaluation
- Liver disease assessment
- Disseminated Intravascular Coagulation (DIC) monitoring
- Alpha-2-antiplasmin deficiency investigation
Result Interpretation
Normal Value Ranges
- Standard range: 90-240 minutes
- Significant age-related variations
- Laboratory-specific reference ranges critical
Abnormal Result Implications
- Shortened ECLT Indicates:
- Hyperfibrinolysis
- Disseminated Intravascular Coagulation (DIC)
- Advanced liver disease
- Prolonged ECLT Suggests:
- Active antifibrinolytic therapy
- Congenital Plasminogen Activator Inhibitor-1 (PAI-1) excess
- Chronic inflammatory conditions
