The APTT can be rather sneaky at times! In part one of this case we saw how the APTT can be prolonged in factor deficiencies.

You are working in a small hospital and the surgical team request fresh frozen plasma for a patient prior to surgery. The patient is 42 years old and female and has short bowel following resection for Crohn’s disease. She needs to go for another procedure, but the coagulation profile shows:

• PT 14s (11-14s)
• APTT 56s (33-40s)
• Fibrinogen (Clauss) 6.9g/L (1.5-4.5g/L)
• FBC – normocytic anaemia

Questions:

• How do you approach this problem?
• Is FFP the best way forward?

Please reply to us (@teamhaem) on Twitter and always include #teamhaem to allow others to follow your comments. Please join in the debate and learn about haematological problems along the way. The case will continue to  evolve over the coming week so keep checking #teamhaem for more information.

Please note – all cases on TeamHaem are entirely fictional to protect patient confidentiality.

TeamHaem are not a position of authority.  It is an educational platform to allow discussion and learning.