What should be the laboratory approach against isolated prolongation of a activated partial thromboplastin time?

Falay, Mesude; Şeneş, Mehmet; Yücel, Doğan; Turhan, Turan; Dağdaş, Simten; Pekin, Melike; Nazaroğlu, N. Kemal; Özet, Gülsüm

doi:10.1002/jcla.22415

Cited by 6 publications

(8 citation statements)

References 20 publications

(77 reference statements)

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“…From the viewpoint of clinical medicine, two conflicting disease categories, such as hemorrhagic diseases and thrombotic diseases, should be considered. Hemorrhagic disease is AHA, and thrombotic disease is antiphospholipid syndrome with positive lupus anticoagulant [3]. AHA exhibits reduction of FVIII levels.…”

Section: Discussionmentioning

confidence: 99%

A Case of a Patient Who Is Diagnosed with Mild Acquired Hemophilia A after Tooth Extraction Died of Acute Subdural Hematoma due to Head Injury

Kitamura

Sato

Ikami

et al. 2018

Case Reports in Dentistry

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Background Acquired hemophilia A (AHA) is a rare disorder which results from the presence of autoantibodies against blood coagulation factor VIII. The initial diagnosis is based on the detection of an isolated prolongation of the activated partial thromboplastin time (aPTT) with negative personal and family history of bleeding disorder. Definitive diagnosis is the identification of reduced FVIII levels with evidence of FVIII neutralizing activity. Case report We report a case of a 93-year-old female who was diagnosed as AHA after tooth extraction at her home clinic. Prolongation of aPTT and a reduction in factor VIII activity levels were observed with the presence of factor VIII inhibitor. AHA condition is mild. However, acute subdural hematoma of this patient occurred due to an unexpected accident in our hospital. Hematoma was gradually increased and the patient died 13 days after admission. Discussion Although AHA is mild, intracranial bleeding is a life-threatening condition. We also should pay attention to the presence of AHA patients when we extract teeth.

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Section: Discussionmentioning

confidence: 99%

A Case of a Patient Who Is Diagnosed with Mild Acquired Hemophilia A after Tooth Extraction Died of Acute Subdural Hematoma due to Head Injury

Kitamura

Sato

Ikami

et al. 2018

Case Reports in Dentistry

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“…In preparation for this review, a PubMed search comprising the search terms (“postanalytical” OR “post‐analytical”) AND (“Willebrand” OR “haemophilia” OR “hemophilia”) only captured 4 documents, not all of which were relevant to haemophilia/VWD, and thus confirming a serious under‐recognition of the influence of postanalytical issues on VWD and haemophilia diagnosis/exclusion, or perhaps more correctly reflective of increased potential for “misdiagnosis” of VWD or haemophilia. Postanalytical considerations reflect events after the test has been performed.…”

Section: An Overview Of Preanalytical Analytical and Postanalytical mentioning

confidence: 99%

Postanalytical considerations that may improve the diagnosis or exclusion of haemophilia and von Willebrand disease

2018

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von Willebrand disease (VWD) and haemophilia represent the most common inherited or acquired bleeding disorders. However, many laboratories and clinicians may be challenged by their accurate diagnosis or exclusion. Difficulties in diagnosis/exclusion may include analytical issues, where assays occasionally generate an incorrect result (ie representing an analytical error) or have limitations in their measurement range of and/or low analytical sensitivity. Also increasingly recognized is the influence of preanalytical issues on the diagnosis of VWD or haemophilia. Unfortunately, postanalytical considerations are often not well considered in the diagnostic process. Therefore, this narrative review aims to provide an overview of some important postanalytical considerations that may help improve the diagnosis of VWD and haemophilia. This review primarily discusses aspects around reporting of test results. However, we also discuss other less well-recognized postanalytical considerations, including the use of assay ratios to help identify differential diagnoses and then guide further investigation.

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“…However, these studies were performed using frozen samples, and no sex stratification was applied. There have been concerns regarding the quality of the earlier studies on BV, and consequently, the reliability of the BV estimates reported in these studies as well as the online 2014 BV database…”

Section: Introductionmentioning

confidence: 99%

“…stratification was applied. There have been concerns regarding the quality of the earlier studies on BV, 1,2 and consequently, the reliability of the BV estimates reported in these studies as well as the online 2014 BV database. 3 In this study, we aimed to determine BV estimates for PT, aPTT, and fibrinogen tests by analyzing fresh plasma samples following 1 hour of sampling.…”

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confidence: 99%

Biological variation estimates of prothrombin time, activated partial thromboplastin time, and fibrinogen in 28 healthy individuals

Falay

Şeneş

Korkmaz

et al. 2018

Int J Lab Hematology

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What should be the laboratory approach against isolated prolongation of a activated partial thromboplastin time?

Abstract: Prolonged APTT results should always be retested using a different assay prior to mixing study. The clinician and the laboratory specialist should collaborate at the postanalytical phase.

Cited by 6 publications

References 20 publications

A Case of a Patient Who Is Diagnosed with Mild Acquired Hemophilia A after Tooth Extraction Died of Acute Subdural Hematoma due to Head Injury

A Case of a Patient Who Is Diagnosed with Mild Acquired Hemophilia A after Tooth Extraction Died of Acute Subdural Hematoma due to Head Injury

Postanalytical considerations that may improve the diagnosis or exclusion of haemophilia and von Willebrand disease

Biological variation estimates of prothrombin time, activated partial thromboplastin time, and fibrinogen in 28 healthy individuals

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