Aniara | Shaping the Future with Innovative Solutions

Learning Center

Coagulation Case Studies

Friday, May 2, 2008

Bleeding or Clotting that is the question?

An 18 year old male has right knee arthroscopy with a diagnosis of hemarthrosis. His own history is insignificant for bleeding, no epistaxis, gum bleeding, non bleeding at circumcision. The family history -- father had a prolonged APTT pre-operatively in his 40's, treated with DDAVP and diagnosed with von Willebrand's disease, grandfather is in his 80's with no history of bleeding, half-sister has a strong history of menorrhagia but is negative for von Willebrand disease.

Physical examination reveals joint laxity.

Coagulation testing results as follows:
PT= 13.7 sec (10.5-13.0)
1:1 mix = 11.2 sec
Control = 11.0 sec
APTT= 33.9 sec (24.5-34.5)
Fibrinogen= 282 mg/dL (180-400)

Fac VII = 33% (50-150%)
Fac 8 = 99% (50-150%)
vWF activity = 59% (50-150%)
vWF antigen = 78% (50-150%)
PFA/ADP = 68 sec (56-128 sec)
PFA/EPI = 139 sec ( 74-186 sec)

  • Does this patient have von Willebrand Disease?
  • What is the most obvious diagnosis?
  • What might be alternative diagnosis?
  • What is the significance of joint laxity?
  • What would be the final diagnosis and how would you treat this?

Donna Castellone

Bookmark and Share


About the Author

Donna Castellone,  MS, MT(ASCP)SH

Donna Castellone,

View Complete Profile


Previous Posts


RSS Feed

This website contains information on products which is targeted to a wide range of audiences and could contain product details or information otherwise not accessible or valid in your country. Please be aware that we do not take any responsibility for accessing such information which may not comply with any legal process, regulation, registration or usage in the country of your origin.