Schindhelm Roger K, Wondergem Mariëlle J, Admiraal Joke, Nap Gert, Boekel Edwin Ten, Hani Lahcen
Department of Clinical Chemistry, Haematology and Immunology, Medical Centre Alkmaar, Alkmaar, The Netherlands.
Case Rep Neurol. 2012 May;4(2):131-6. doi: 10.1159/000342193. Epub 2012 Aug 22.
We report on a 57-year-old woman with a pontine haemorrhage and an extremely prolonged activated partial thromboplastin time (aPTT) of more than 240 s, suggestive of a coagulation disorder. Given the location of the haemorrhage, which is associated with a high mortality rate, recombinant factor VIIa was administered, although not all necessary laboratory analyses could be performed at that time. In our case, a deficiency of factor XII was found, which is not associated with an increased bleeding risk. In an acute setting, evaluation of a prolonged aPTT may cause diagnostic and therapeutic challenges, in particular in situations where additional laboratory investigations may not be readily available.