Age-associated developmental changes in the activated partial thromboplastin time (APTT) and causes of prolonged APTT values in healthy Chinese children

Li, Jianxin; Lai, Xin; Yan, Chaowu; Xu, Anping; Nie, Liping; Zhou, Yu; Liao, Chaoyu; Ren, Hanyun

doi:10.1515/cclm.2009.339

Cited by 16 publications

(15 citation statements)

References 47 publications

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“…The noticeable positive correlation of FVIII plasma levels with the blood donor’s age is consistent with a large number of publications [10, 33, 34, 35], even if the occasional study does not identify an age dependency [15, 36–38]. In line with other studies [10, 14, 15, 35, 39], a significant association with gender cannot be inferred.…”

Section: Discussionsupporting

confidence: 88%

“…This is also corroborated by a comparison between the normal range of these three parameters, derived from the levels of control cohort 3, with the central 95% ranges of study cohorts 1 and 2 which are almost identical. Due to an inclusion of younger populations and an age spectrum of up to 70 years, some studies have reported larger differences in aPTT [36, 37, 40], FVIII [33, 35] and fibrinogen [41, 42] levels.…”

Section: Discussionmentioning

confidence: 99%

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Fresh frozen plasma quality: relation to age and gender of blood donors

et al. 2011

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International Normalized Ratio, aPTT, FVIII, FV, fibrinogen and protein S, as quality indicators for the efficacy of therapeutic plasma, revealed a moderate correlation with age and gender. Compared with the usual reference ranges, the differences were not significant enough to identify any relevant imbalance between procoagulating, anticoagulating and fibrinolytic factors that might influence product quality where the increasing age of the donors or the preference of male donor plasma was concerned.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Fresh frozen plasma quality: relation to age and gender of blood donors

et al. 2011

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“…Therefore, the prolongation of APTT in childhood detected by Actin FS most likely displays the reduced levels of related single coagulation factors VIII, IX, XI and XII. Besides reduced levels of intrinsic factors, the values measured by Pathromtin SL may partially be explained by the higher incidence of transient anticoagulants found in pediatric patients [9][10][11]. Klarmann et al [12]used the same method to measure APTT (Pathromtin SL on the BCS); in summary, the results are very comparable, except for the children < 1 year, who presented with longer clotting times in our study.…”

Section: Discussionsupporting

confidence: 60%

Age dependency of coagulation parameters during childhood and puberty

Appel

Grimminck

Geerts

et al. 2012

Journal of Thrombosis and Haemostasis

106

109

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To cite this article: Appel IM, Grimminck B, Geerts J, Stigter R, Cnossen MH, Beishuizen A. Age dependency of coagulation parameters during childhood and puberty. J Thromb Haemost 2012; 10: 2254-63.Summary. Background: Use of age-adjusted reference values is crucial for correct diagnosis and management of thrombotic and hemorrhagic disease in children. They vary with utilized reagents and analyzers. Objectives: We established reference values with the Sysmex CA-1500 System and in parallel with the Behring BCS System using reagents from Siemens Healthcare Diagnostics Products GmbH. Methods: After informed consent, blood samples were obtained from 218 healthy children and 52 healthy adults, grouped as 1-6 months (n = 29), 7-12 months (n = 25), 1-5 years (n = 57), 6-10 years (n = 57), 11-18 years (n = 50) and > 19 years (n = 52). Results: Most coagulation parameters demonstrate good comparability between analyzers with the exception of PT and APTT. Single coagulation factors fibrinogen, factor (F) II, FIX, FXI and XII were significantly decreased in the youngest children; the strongest age dependency was found for coagulation inhibitors Protein C and S, both significantly decreased in infancy and young childhood. We confirmed that high levels of von Willebrand factor are found in the youngest children without increased levels of FVIII followed by decreased von Willebrand levels in the subsequent age group. In children with blood group O a less distinct increase in time was found, compared with individuals with one of the other blood groups. Conclusions: The correlation between the CA-1500 and the BCS system was remarkable. Differences were most pronounced between children < 12 months and older children and adults, confirming the phenomenon of developmental hemostasis. The rationale for age-related changes in the hemostatic system remains unraveled. Our results underline the need for age-specific reference ranges.

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“…This could be explained due to pre-analytic factors that were corrected, for example there are difficulties known regarding sample recovery from pediatric patients such as: anatomical conditions, or anxiety of the child, parent or caretaker. Another possibility is the presence of transitory LA, which correlates with the peak in prevalence of LA around 5 years of age reported by Male et al, corresponding with the age group analyzed in the present study [20] and the levels of LA reported as a cause of isolated prolonged aPTT in literature. These reports exceed the levels that we could confirm in our study (up to 53, 1% v/s 10% respectively) [2] [13] [14] [17] [21].…”

Section: Discussionsupporting

confidence: 84%

Final Diagnosis of Pediatric Patients with Prolonged in Activated Partial Thromboplastin Time Preoperative Study

Aguirre¹,

Córdova²,

Jaime³

et al. 2015

IJOHNS

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Introduction: Activated partial thromboplastin time (aPTT) is one of the most used coagulation tests in preoperative evaluation. Incidental detection of a prolonged aPTT is a problem in primary care, in which the general pediatrician should be able to attend its initial management. Objective: To describe final diagnosis of patients with prolonged aPTT in preoperative study. Materials and Methods: This is a descriptive study of patients referred from otorhinolaryngology. Results: Totally, 508 adenoidectomies and/or tonsillectomies were performed in our center, 38 of which referred patients (7.5%) with prolonged aPTT, and 30 of which met inclusion criteria. The median age was 4 years. 56.6% of patients were males. 76.6% of patients normalized aPTT at the second follow-up. Among these, 73.9% showed a normal study, 4.3% ha2d lupus anticoagulant and in 21.7% Von Willebrand disease was detected. Among patients that persisted with prolonged aPTT, 42.8% had coagulant factors deficiency, 28.5% had lupus anticoagulant and in 28.5% of patients a diagnosis could not be achieved with the tests used in the present study. Multivariate analysis did not show correlation between final diagnosis and the variables measured. Conclusion: The presence of a prolonged aPTT in children under preoperative study is due to a pre-analytic factor in the majority of cases or to the presence of lupus anticoagulant, normalizing values on follow-up. We suggest that a new aPTT be performed on these patients, and only those that persist altered or present a symptoms and family history of coagulation disorders be referred to hematology. N. Aguirre et al. 242

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Age-associated developmental changes in the activated partial thromboplastin time (APTT) and causes of prolonged APTT values in healthy Chinese children

Abstract: Background: The concept of developmental hemostasis has been universally accepted. Physiological reference ranges for coagulation tests are available for infants and children of different ages. However, on Oriental children they are rare.

Cited by 16 publications

References 47 publications

Fresh frozen plasma quality: relation to age and gender of blood donors

Fresh frozen plasma quality: relation to age and gender of blood donors

Age dependency of coagulation parameters during childhood and puberty

Final Diagnosis of Pediatric Patients with Prolonged in Activated Partial Thromboplastin Time Preoperative Study

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