Tag Archives: Lupus anticoagulant

Case 82 – Update 3

Thanks for your continued contributions for this tricky case! We’ve got some new investigations results from what you have requested: Peak anti-Xa levels on re-admission: 0.84. INR 2.2. No evidence of malignancy on recent CTPA / CT abdo pelvis. HIT … Continue reading

Posted in Anticoagulation | Tagged , , , , , ,

Case 82 – update 2

Our patient continues to deteriorate and the following investigations are now back: Hb 103, Plts 75, WCC 3.4, Neuts 1.6. Blood film: red cell fragments with infrequent spherocytes and polychromasia. Bili 152 (predominantly conjugated), ALT 54, Alk phos 340. Urea … Continue reading

Posted in Anticoagulation, Thrombosis | Tagged , , , , , ,

Case 82 – update 1

Thanks for all the contributions! We now know from the history and investigations requested that: This patient has had no obvious provoking factors for both his previous and current PE – including no symptoms/signs suggestive of autoimmune disorder / maligancy. … Continue reading

Posted in Anticoagulation, Thrombosis | Tagged , , , , , ,

Case 58 – update 4

Our patient has a confirmed left sided DVT. Prior to initiation of anticoagulation a clotting screen is performed. It shows: PT 12s (11-14) APTT 49s (35-40) Fibrinogen 5.5g/L (1.5-4) d-dimer 990ng/mL (<500)   Questions How do you interpret the results? … Continue reading

Posted in Anticoagulation, Thrombosis | Tagged , , , , , , , , ,

Case 37 part 3 – summary

Our patient was unwell with pneumonia. The results showed an isolated prolonged APTT: PT 14s (11-14s) APTT 48s (33-40s) APTT 50:50 mix 47s Fibrinogen (Clauss) 4.9g/L (1.5-4.5g/L) Thrombin time 16s (15-19s) She was not on any anticoagulation and had no … Continue reading

Posted in Inherited bleeding, Thrombosis | Tagged , | 1 Comment

Case 37 part 3 – update 1

The patient is rather unwell with a community acquired pneumonia and requiring supplemental oxygen and intravenous antibiotics. She is not ‘septic’ with low BP etc. There is no history of bleeding and the coagulation screen 5 years pre knee operation … Continue reading

Posted in Inherited bleeding, Thrombosis | Tagged , | Leave a comment

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

Posted in Inherited bleeding, Thrombosis | Tagged , , | Leave a comment

Case 26 – update 3

To summarise: 38 year old man with incidental finding of a prolonged APTT on pre-op bloods. History: major orthopaedic surgery without bleeding. Some bleeding post dental extraction but no intervention needed. No family history. Investigations: no LA. Factor assays show … Continue reading

Posted in Inherited bleeding | Tagged , , | Leave a comment

Case 26 – update 1

So, our patient has a prolonged APTT. There were loads of suggestions and comments from you all about what you would do next. To summarise: Get more information – a reasonable request! A few people highlighted the need to check … Continue reading

Posted in Inherited bleeding | Tagged , , , | Leave a comment