We have a 7 year old boy who has presented with bruises over abdomen and one on his ear.
Social services have been contacted as there is concern this may be an NAI.
The boy is otherwise well has no family history of bleeding disorders and has no bleeding history of note.
The boy was asked to attend the tertiary centre for coagulation tests to be performed. This is because of concerns regarding delay in transportation of samples. If further special tests like platelet function required would also need to be taken at site that can perform the tests.
Tests taken and results:
- Full blood count, blood film – Normal
- PT 13 sec (Normal) APTT 50 sec (Prolonged), thrombin time – Normal, Clauss fibrinogen 3.2 (Normal)
- Von Willebrand screen – Normal
- Lupus screen – Normal
- 50:50 mix APTT – 37 Sec (Normal)
- FVIII level – 100% (Normal)
- FIX level – 96% (Normal)
- FXI level – 110% (Normal)
- FXII level – 30% (Low)
What is the likely cause for the prolonged APTT?
Does this explain the bruises in this case?
Would you perform any other tests in this case?