Case 64 – part 1a

This week we’re going to present a series of short cases around clotting results. Hopefully we’ll demonstrate when coagulation screens should be used and also how to interpret basic abnormalities. It most be noted that different labs will use different reagents and therefore sensitivities to certain abnormalities may be different.  Please reply on Twitter @teamhaem and use the #teamhaem

 

A 75 year old gentleman has a routine clotting screen performed pre pacemaker insertion. The results show:

  • PT 13s (11-14s)
  • APTT 46s (33-40s)
  • Fibrinogen (Clauss) 3.4g/L (1.5-4.5g/L)
  • FBC – normal

 

Questions:

  • What is your first step?
  • What is the most common reason for abnormal coagulation?
  • Can you propose further investigation?

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 on Twitter 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.

 

About TeamHaem

Online education and discussion about all things haematological
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