TY - JOUR
T1 - Troubleshooting an isolate prolongation of activated partial thromboplastin time in a patient with acute myocardial infarction
T2 - A paradigmatic case report
AU - Poli, Giovanni
AU - Castiglioni, Piero
AU - Montagnana, Martina
AU - Favaloro, Emmanuel J
AU - Lippi, Giuseppe
PY - 2016/11
Y1 - 2016/11
N2 - We describe here the case of a 46-year-old man admitted to the emergency department (ED) and diagnosed with a non-ST elevation myocardial infarction. Before referring the patient to the coronary care unit and initiating antiplatelet and anticoagulant therapy, a highly prolonged activated partial thromboplastin time (APTT) was observed among results of laboratory testing. Results of mixing test showed complete correction of APTT, thus ruling out the presence of inhibitors of blood coagulation. On the following day, second line coagulation testing revealed normal activity of all clotting factors except factor XII, the concentration of which was found to be 1.5%. This result was suggestive for a diagnosis of inherited factor XII deficiency, thus highlighting the importance of combining clinical history, symptoms and results of first-line coagulation tests in similar emergency conditions.
AB - We describe here the case of a 46-year-old man admitted to the emergency department (ED) and diagnosed with a non-ST elevation myocardial infarction. Before referring the patient to the coronary care unit and initiating antiplatelet and anticoagulant therapy, a highly prolonged activated partial thromboplastin time (APTT) was observed among results of laboratory testing. Results of mixing test showed complete correction of APTT, thus ruling out the presence of inhibitors of blood coagulation. On the following day, second line coagulation testing revealed normal activity of all clotting factors except factor XII, the concentration of which was found to be 1.5%. This result was suggestive for a diagnosis of inherited factor XII deficiency, thus highlighting the importance of combining clinical history, symptoms and results of first-line coagulation tests in similar emergency conditions.
KW - Myocardial infarction
KW - factor XII
KW - Activated partial thromboplastin time (APTT)
KW - mixing test
KW - laboratory diagnostics
U2 - 10.21037/atm.2016.11.17
DO - 10.21037/atm.2016.11.17
M3 - Article
C2 - 27942517
SN - 2305-5839
VL - 4
JO - Annals of Translational Medicine
JF - Annals of Translational Medicine
IS - 21
ER -