Haemostasis Case
Study 1
A 55 year old female visited her GP with frequent nose. Blood samples were sent for a
coagulation screen (PT &APTT) and FBC.
Results Normal Range
WBC 6.2 x 109/L 4.0-10.0 x109/L
Hb 148 g/L 130-170 g/L
9
Plt 235 x10 /L (150-400 x109/L)
PT 18.6 secs (11- 16 secs)
APTT 48 secs (30-40 secs)
Fibrinogen 2.2 g/L 1.5-4.0g/L
1. What do the initial tests indicate?
PT time too high - takes longer to coaggulate
Problem with the intrisic and comon - because APTT is too high
2. Correction tests were also carried out
Test Result
Aged normal serum APTT Corrected
(contains FVII, FIX, FX, FXI, FXII)
Adsorbed plasma APTT Not Corrected
(contains FI, FV, FVIII, FXI, FXII)
Deduce ‘step-by’step’ the condition the patient is suffering from by considering:
Factors in aged serum and factors in adsorbed serum
What it means if the test is corrected.
Factors that have helped correct it, are the 7, 9, 10
3. What additional test could be done to confirm diagnosis?
Factor 10, 9 and 7 assay to eliminate certain pathways
4. What would you suggest may be the cause of this condition?
Vitamin K deficiency, warfarin , liver disease causes less coagulation factors to be produced
Study 1
A 55 year old female visited her GP with frequent nose. Blood samples were sent for a
coagulation screen (PT &APTT) and FBC.
Results Normal Range
WBC 6.2 x 109/L 4.0-10.0 x109/L
Hb 148 g/L 130-170 g/L
9
Plt 235 x10 /L (150-400 x109/L)
PT 18.6 secs (11- 16 secs)
APTT 48 secs (30-40 secs)
Fibrinogen 2.2 g/L 1.5-4.0g/L
1. What do the initial tests indicate?
PT time too high - takes longer to coaggulate
Problem with the intrisic and comon - because APTT is too high
2. Correction tests were also carried out
Test Result
Aged normal serum APTT Corrected
(contains FVII, FIX, FX, FXI, FXII)
Adsorbed plasma APTT Not Corrected
(contains FI, FV, FVIII, FXI, FXII)
Deduce ‘step-by’step’ the condition the patient is suffering from by considering:
Factors in aged serum and factors in adsorbed serum
What it means if the test is corrected.
Factors that have helped correct it, are the 7, 9, 10
3. What additional test could be done to confirm diagnosis?
Factor 10, 9 and 7 assay to eliminate certain pathways
4. What would you suggest may be the cause of this condition?
Vitamin K deficiency, warfarin , liver disease causes less coagulation factors to be produced
