- A 2-year-old girl is brought to your clinic.Developmentally normal, her parents had noticed her to be bruisingeasily.
Coagulation tests show:
Test | Patient | Reference Range |
PT | 13s | 11-14s |
APTT | 105s | 23-35s |
Fibrinogen (Clauss) | 2.7g/L | 1.5-4.0g/L |
Thrombin Time | 13s | 10-13s |
1. What additional questions might you ask theparents?
2. Briefly outline how you would investigate the clottingabnormalities.
3. What are the possible explanations for theseresults?
The prolonged PT and APTT correct in a mix with normalplasma.
A 10-day-old baby, previously well, breast fed and bornat home is found by his parents unconscious and bleeding from mouthand gums. The only history of note is that the mother had had amajor post-partum haemorrhage and had required emergency admissionto hospital.
A coagulation screen shows:
Test | Patient | Reference Range |
PT | 102s | 11-14s |
APTT | >120s | 23-35s |
Fibrinogen (Clauss) | 1.9g/L | 1.5-4.0g/L |
Thrombin Time | 13s | 10-13s |
1. What is the most likely diagnosis?
​​​​​​​2. How would you confirm this?
3. Why does this occur?
