Tag Archives: APTT

Case 92 – summary

Thanks for your help with the cases. This week we have looked at three different scenarios regarding bleeding or bruising presenting in the paediatric population. The cases although different have some common themes: Coagulation testing in paediatrics is challenging for … Continue reading

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Case 92- update part C

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 … Continue reading

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Case 92 – part C

Thanks for your help with case 2 the patient has been diagnosed with Ehlers Danlos and will have an echo arranged to check for any cardiac problems. You now receive a call from the local district general hospital regarding a … Continue reading

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Case 74 – summary

Thankyou for your input this week!This week we had a look at a few abnormalities that can be seen on coagulation screens in a pre procedure setting. The first thing to say is there is no replacement for a good … Continue reading

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Case 74 – part 3

We have our 3rd and final case of the week! A 40 year old man who has a vasculitis ,who has been requiring plasma exchange, needs to have a new line put in for exchange. The renal team are concerned … Continue reading

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Case 74 – part 2

So our second case starts with a phone call from the anaesthetic consultant in the pre op clinic. He has a 20 year old man that needs a wide excision of a suspicious mole on his back.  He has been … Continue reading

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Case 74 – part 1

Welcome to our new teamhaem cases!This week we will run through some short cases with pre operative coagulation screen abnormalities! Our first patient is a 25 year old male who has been admitted to the surgical assessment unit with abdominal … Continue reading

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Case 64 – part 1 – summary

We started with a 72 year old gentleman who was having an elective pacemaker insertion. He had an isolated prolonged APTT and we have previously used the following flow chart to make a diagnosis:   It should be remembered that … Continue reading

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Case 64 – part 1c

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 … Continue reading

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Case 64 – part 1b

The patient with abnormal clotting resulst goes ahead with his planned pacemaker insertion. There is no major bleeding during the procedure but afterwards there is a large haematoma around the pocket with extensive bruising.   Repeat clotting screen shows: PT … Continue reading

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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 … Continue reading

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Case 53 – summary

Lauren is a 34 year old woman with a postpartum acquired haemophilia. The presentation and diagnosis of this disorder has been discussed in the previous posts; the management is what concerns us at this point. The traditional approach to the … Continue reading

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Case 53 – update 2

Lauren, 34 had a baby 4 months ago and recently consulted her GP with marked easy bruising. Her GP did some blood tests which revealed a prolonged APTT at 69 seconds. The lab did extra tests to establish than rather … Continue reading

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Case 53 – update 1

Yesterday we met Lauren, a 34 year old who went to see her GP with easy bruising. She felt this was a new problem, although she mentioned her sister bruised easily. We explored this a little further. Her sister had … Continue reading

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Case 53 – the beginning

Welcome to the new case for the week. Please read the case, consider the questions posed and share your thoughts via twitter using #teamhaem @teamhaem. Lauren is a 34 year old woman who contacted her GP when she developed some … Continue reading

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Case 37 part 3 – the beginning

Welcome back. Case 37 has focused around an abnormal APTT. This is a common finding in the routine coagulation screen. It is important to investigate appropriately to avoid delayed procedures and patient anxiety. The first case had a factor XII … Continue reading

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Case 37 part 2 – summary

The key to this mini case was the history. The patient had had numerous previous operations without problems. Therefore inherited bleeding disorder is unlikely. The clotting screen had previously been normal so an acquired problem is what we’re dealing with. … Continue reading

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Case 37 part 2 – update 1

Here are some results that may help: PT 14s (11-14s) APTT 56s (33-40s) Fibrinogen (Clauss) 6.9g/L (1.5-4.5g/L) Thrombin time 38s (15-19) Questions What has happened here? Please reply to us (@teamhaem) on Twitter and always include #teamhaem to allow others … Continue reading

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Case 37 part 2 – the beginning

The APTT can be rather sneaky at times! In part one of this case we saw how the APTT can be prolonged in factor deficiencies. You are working in a small hospital and the surgical team request fresh frozen plasma for … Continue reading

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Case 37 part 1 – summary

Our patient has factor XII deficiency. Factor XII is needed in the activation of the clotting cascade when measuring the APTT in the laboratory (via contact factor). However it is not required in life to activate clotting. Hence people do not … Continue reading

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