Case 37 part 1 – update 2

Our patient who is pre-op has had a routine coagulation screen has a prolonged APTT which corrects on mixing with normal plasma, indicating a possible coagulation factor deficiency. If the APTT does not correct it would suggest an antibody interfering with the test (e.g. lupus anticoagulant). As has been suggested things aren’t always ‘cut and dry’!

Coag

We have performed some further tests:

  • VIII – 75u/dL (55-150)
  • XI – 82u/dL (70-165)
  • XI – 72u/dL (65-135)
  • XII – 23u/dL (60-125)

Questions

  • What is the diagnosis?
  • What should you tell the patient?
  • Can he have his surgery?

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