Our patient has a long APTT and has a haematoma and extensive bruising following pacemaker insertion. He is not on any anticoagulation, but does not have any previous clotting screens to compare to. Given the bleeding history, FFP is administered and factor assays are requested. These show:
- VIII 28% (50-100%)
- IX 79% (50-100%)
- XI 82% (65-100%)
- XII 80% (50-100%)
- Inhibitor screen – not detected
- vWF screen – normal
- Are there any other tests that can be done to confirm the diagnosis?
- What is your management strategy?
- Are there any other considerations?
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