Case 76 – the beginning

You are working in the emergency department of a district general hospital. Parents bring a three day old child in for assessment as he has been non-specifically unwell, looking pale and feeding poorly. He was born at term by spontaneous vaginal delivery and was allowed home a day later. APGAR scores were 9 at one and five minutes. He has some bleeding around his umbilical stump so a FBC and coagulation screen were checked:

  • FBC – within reference range
  • PT 19s (12-14 adult)
  • APTT 89s (30-38 adult)
  • Clauss fibrinogen 2.5g/L (2-4)
  • Glucose – normal



  • What are your differential diagnosis of the coagulation results?
  • What are you concerned about with the baby?


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