The coagulation panel demonstrated a slightly increased international normalised ratio (INR: 1.4) and partial prothrombin time (PTT: 37 s).
Adding the more subtle findings of fatigue and recurrent nose bleeding over the last weeks, a nonpitting oedema on the lower legs, an elevated bicarbonate as a sign of a chronic hypoventilation, an elevated creatine kinase (CK-MM), and a slightly altered coagulation panel, this patient showed several signs and symptoms of hypothyroidism.
On the third day of hospitalization, the coagulation panel
was normal: international normalized ratio, 1.08; activated partial thromboplastin time, 35.1 seconds.
Mild hyponatremia (sodium 132 mmol/L [reference 135-145 mmol/L]) also was noted; otherwise the test results were unremarkable, including normal platelet count and coagulation panel
. Serologic tests were positive for anti-dengue virus IgM but negative for anti-dengue virus IgG: viral RNA was not detected.
Her coagulation panel revealed a prothrombin time of 13.1 seconds, and an international normalized ratio of 1.3.
* a complete blood count, metabolic panel, and coagulation panel
The coagulation panel
included: Normal PT (11 sec) and PTT (28 sec), normal platelet count (180,000), abnormal platelet function tests (PFA100[R]), prolonged bleeding time (10 min), low vWF:RCo (26 IU/dl), low vWF:Ag (24 IU/dl), and normal Factor VIII (112.3 IU/dl).
The patient's coagulation panel
eventually resulted in a resolving DIC septic-type picture due to retained placental parts.
A coagulation panel
(PT, aPTT, thrombin clot time, fibrinogen, platelet count, platelet function assay and/or bleeding time) is recommended in the initial work-up of a patient who presents with prolonged bleeding or hemearthrosis.
Prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, and D-dimer assays are part of the conventional routine coagulation panel
. Accurate standardization of both the preanalytical and analytical phases is pivotal to achieving accuracy and precision of results.