Case 76 – update 1

Our three day old child is admitted unwell and has deranged clotting with a markedly prolonged APTT. The team wanted an ultrasound scan which confirms a small intraparenchymal bleed. Repeat coagulation testing shows:

  • PT 18s (12-14 adult)
  • APTT 92s (30-38 adult)
  • APTT 50:50 mix with normal plasma 38s
  • Clauss fibrinogen 2.6g/L (2-4)

Liver function tests are within normal limits. The parents are fit and well with no past medical history. The pregnancy was uneventful save for an element of iron deficiency which resolved with supplementation.


  • Given the clinical history and the coagulation results what are the differential diagnoses?
  • What does 50:50 mix mean?
  • You’re in a district general hospital – what would be your immediate management?


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
This entry was posted in Inherited bleeding, Paediatric haematology and tagged , , , , , , , . Bookmark the permalink.