Sequential thrombosis and bleeding in a woman with a prolonged activated partial thromboplastin time.
Simultaneous or sequential haemorrhage and thrombosis in the presence of a prolonged activated partial thromboplastin time (aPTT) is a rare occurrence: we describe the case a 37 year old lady who developed post-delivery deep vein thrombosis treated with low molecular heparin and warfarin followed a week later by extensive bruising over legs and forearms, a significant drop in haemoglobin and a very prolonged aPTT. Further tests revealed an acquired factor VIII inhibitor at 35 Bethesda Units. We discuss the clinical and laboratory implications and provide a literature review of simultaneous thrombophilia and haemophilia in the presence of a prolonged aPTT.
Department of Haematology, Airedale Foundation Trust, Steeton, BD20 6TD, UK. paxmes@aol.com.
Akpan
A
Spencer
Michael I
MI
Pearce
Paul Rj
PR
Ames