Our Quick Question case study for April, 2019, is adapted from Chapter 35 of the March, 2019 6th edition of Rodak's Hematology, Clinical Principles and Applications:
Posts - Lupus Anticoagulant
Apr 3, 2019 1:09pm
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Nov 8, 2017 6:36pm
From Dean Willett, Precision BioLogic Inc. As I read the 11-8-17 comments from Dr. Elman a bit of a lightbulb went off in my head.
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Nov 8, 2017 4:11pm
From "Ari." Hi George, I stumbled upon your amazing site when researching this question and was wondering if you could shed some light on this. I have a patient who had a DVT. His PCP noted a slightly prolonged aPTT
and sent mixing studies. From what I can tell, the aPTT
mostly corrected with mix, but the PTT-LA is definitely long and only slightly corrects (basically it stays prolonged). I understand the PTT-LA results as indicative of a lupus anticoagulant (LAC
) which fits the clinical picture of DVT
, but I'm having trouble understanding why the aPTT
would correct on mixing. Can you shed some light on this?
I've copied the relevant labs with patient identifying factors removed to this link: https://imgur.com/a/e0ubV. (Readers go to the link for the patient data, Geo.)
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Apr 22, 2017 7:40am
An intriguing case from Heather DeVries, Indiana University Health.
Hi George, I have an interesting (cold) case study for you. We recently tested a 44 yo
female for lupus antibodies and she had textbook results--nothing equivocal about them. Her history includes a late-term pregnancy loss 12 years ago, and a recent diagnosis of lupus, so it seems that she could now be considered to have antiphospholipid antibody syndrome (APS). This is where the family history comes in.
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