Unexpected, isolated activated partial thromboplastin time prolongation: A practical mini-review
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Unexpected, isolated activated partial thromboplastin time prolongation : A practical mini-review. / Rasmussen, Katrine Laura; Philips, Malou; Tripodi, Armando; Goetze, Jens Peter.
I: European Journal of Haematology, Bind 104, Nr. 6, 2020, s. 519-525.Publikation: Bidrag til tidsskrift › Review › fagfællebedømt
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TY - JOUR
T1 - Unexpected, isolated activated partial thromboplastin time prolongation
T2 - A practical mini-review
AU - Rasmussen, Katrine Laura
AU - Philips, Malou
AU - Tripodi, Armando
AU - Goetze, Jens Peter
PY - 2020
Y1 - 2020
N2 - A common inquiry in coagulation laboratories is how to interpret an unexpected, isolated prolonged activated partial thromboplastin time (APTT). In this context, isolated means together with a normal prothrombin time (PT) and/or normal international normalized ratio (INR). This finding may lead to contact with laboratory doctors for further advice on a diagnostic strategy. Occasionally, the need for a diagnostic algorithm can be subacute, where surgery has to be postponed until an explanation for the isolated, prolonged APTT has been established. Activated partial thromboplastin time as a coagulation test was developed to monitor patients with hemophilia. Different APTT reagents display considerable differences in their sensitivity to deficiencies of coagulation factors. An isolated, prolonged APTT is seen in (a) individuals/patients with lupus anticoagulants, (b) patients in treatment with anticoagulants, mainly heparin, and (c) patients with deficiencies of specific coagulation factors. In this tutorial review, we summarize what may cause an isolated prolonged APTT and we present a simple diagnostic algorithm to differentiate between lupus anticoagulants (common) and factor deficiencies (rare). The identification of an isolated prolonged APTT as well as the underlying cause can be of the utmost importance in ensuring the correct therapeutic follow-up.
AB - A common inquiry in coagulation laboratories is how to interpret an unexpected, isolated prolonged activated partial thromboplastin time (APTT). In this context, isolated means together with a normal prothrombin time (PT) and/or normal international normalized ratio (INR). This finding may lead to contact with laboratory doctors for further advice on a diagnostic strategy. Occasionally, the need for a diagnostic algorithm can be subacute, where surgery has to be postponed until an explanation for the isolated, prolonged APTT has been established. Activated partial thromboplastin time as a coagulation test was developed to monitor patients with hemophilia. Different APTT reagents display considerable differences in their sensitivity to deficiencies of coagulation factors. An isolated, prolonged APTT is seen in (a) individuals/patients with lupus anticoagulants, (b) patients in treatment with anticoagulants, mainly heparin, and (c) patients with deficiencies of specific coagulation factors. In this tutorial review, we summarize what may cause an isolated prolonged APTT and we present a simple diagnostic algorithm to differentiate between lupus anticoagulants (common) and factor deficiencies (rare). The identification of an isolated prolonged APTT as well as the underlying cause can be of the utmost importance in ensuring the correct therapeutic follow-up.
KW - activated partial thromboplastin time
KW - hemophilia
KW - lupus anticoagulants
U2 - 10.1111/ejh.13394
DO - 10.1111/ejh.13394
M3 - Review
C2 - 32049377
VL - 104
SP - 519
EP - 525
JO - European Journal of Haematology
JF - European Journal of Haematology
SN - 0902-4441
IS - 6
ER -
ID: 237416606