Applying a direct aPTT ratio (PlatelinLS/ActinFS) permits to identify rapidly and reliably a bleeding-related factor deficiency or a lupus anticoagulant sequential to an isolated prolongation of aPTT in paediatric pre-operative screening

作者：Li Rong^*; Swaelens Caroline; Vandermijn**rugge Francine; Cantinieaux Brigitte

来源：European Journal of Haematology, 2016, 96(6): 578-585.

DOI：10.1111/ejh.12634

• prolonged activated partial thromboplastin time
• factor deficiency
• pre-operative screening
• ActinFS
• mixing study

ObjectivesAn isolated prolongation of activated partial thromboplastin time (aPTT) found in paediatric pre-operative screening could be due to bleeding or non-bleeding aetiologies. The aim of our study was to evaluate clinical benefits of an additional ActinFS and/or a mixing aPTT study to identify a bleeding-related factor deficiency (BRFD).
MethodsOver a 4-yr period, isolated prolongation of aPTT with PlatelinLS was detected in 308 paediatric patients and confirmed in 161 cases by a 2nd sample. ActinFS, a mixing study, FVIII, FIX, FXI, FXII and lupus anticoagulant (LA) were performed. Three different aPTT ratios between PlatelinLS and ActinFS were analysed.
ResultsWe found 17 BRFD, 31 FXII deficiencies and 64 positive LA. A prolonged ActinFS had a significant association with BRFD (P<0.0001) while a corrected mixing study did not. The direct aPTT ratio had a significant relationship with positive LA (P<0.05), and with BRFD (P<0.0001). Using this ratio, the sensitivity of BRFD's and LA's detection could be increased, respectively, to 82% from 59% using ActinFS alone, and to 86% from 55% using mixing study.
ConclusionsApplying this direct aPTT ratio allows to quickly and reliably identify both BRFD and LA sequential to an isolated prolongation of aPTT.

• 出版日期2016-6