Case 8 A 32-year-old woman being treated for RA was taken to the emergency depar
ID: 3517593 • Letter: C
Question
Case 8
A 32-year-old woman being treated for RA was taken to the emergency department as the result of excess bleeding after a dental extraction.
PT: 11.8 sec
aPTT: 28.4 sec
PLT: 256 109/L
Bleeding time: 20 min
1. Interpret the coagulation screening tests.
2. What additional tests should be performed?
The results of the proposed additional studies were as follows:
PLT aggregation:
Thrombin: normal
Arachidonic acid: diminished secretion and aggregation
Epinephrine and collagen: diminished secretion and aggregation
ADP: no secondary aggregation
3. Based on all the data provided, what condition is most likely?
4. What information is most diagnostic?
Explanation / Answer
1).
Laboratory test
Components measured
Normal values
Patient’s values
Inference
Prothrombin time or PT
I, II, V, VII, IX, X
12-14 seconds
11.8 seconds
Normal
aPTT
I, II, V, VIII, IX, X, XI, XII
24-35 seconds
28.4 seconds
Normal
Platelet count
Platelet number
150–400×109/L
256 109/L
Normal
Bleeding time
Platelet function
3-10 minutes
20 minutes
Increased blooding time
Laboratory test
Components measured
Normal values
Patient’s values
Inference
Prothrombin time or PT
I, II, V, VII, IX, X
12-14 seconds
11.8 seconds
Normal
aPTT
I, II, V, VIII, IX, X, XI, XII
24-35 seconds
28.4 seconds
Normal
Platelet count
Platelet number
150–400×109/L
256 109/L
Normal
Bleeding time
Platelet function
3-10 minutes
20 minutes
Increased blooding time
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