Contributed by Lirong Qu, MD, Ph.D, Kathy Puca, MD, Joseph Kiss, MD and Darrel Triulzi, MD
Published on line in October 2001
PATIENT HISTORY:
An 83-year-old female presented with post-operative bleeding and severe anemia that required multiple transfusions. Initial evaluation revealed an elevated PTT with no other hemostatic abnormalities. Her past medical history includes hypertension, glaucoma, esophagitis, diverticulitis without prior bleeding episode. A coagulation panel on admission is showed in Table 1.
Table
1. Laboratory values
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Parameter |
Value |
Reference
Range |
Platelets |
220,000 |
150,000-400,000 |
PT |
12.5 |
11.5-15.0 |
APTT |
80.3 |
26-36 |
APTT Mix |
81.5 |
32.0-42.0 |
Factor XII |
0.63 |
0.50-1.70 |
Factor XI |
0.96 |
0.65-1.40 |
Factor X |
0.98 |
0.70-1.50 |
Factor VIII |
<0.01 |
0.50-1.50 |
Factor VII |
1.09 |
0.60-1.60 |
Factor V |
1.08 |
0.50-1.50 |
Fibrinogen |
572 |
150-350 |
APTT: Activated Partial Thromboplastin Time. |