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Pediatric Hematology/Oncology • Internal Medicine • Rheumatology • Thrombosis • Hematology • Pediatric Hematology • Antiphospholipid Syndrome • Benign Hematology • Hemostasis/Thrombosis • Neurology • Vascular Neurology
Can anti-cardiolipin or anti-beta-2 glycoprotein antibodies cause prolonged PTT in the absence of a lupus anticoagulant?
Labs with normal PT, but prolonged PTT (47 sec, ULN 40 sec) that does not correct on immediate mix. Lupus anticoagulant negative (DRVVT and hexagonal phase), but extremely high titers of anti-cardiolipin and anti-beta-2 glycoprotein IgMs above quantitative levels. Factor VIII, IX, XI, and XII levels are normal, and the vWD panel is normal. No bleeding or clotting episodes.
Answer from: at Academic Institution
Lupus anticoagulants are a heterogeneous group of antibodies that do not have uniform activity in all assays. Furthermore, testing procedures are not well-standardized. Since relevant clotting factor deficiencies have been ruled out and the long PTT does not correct with mixing, and since there is o...
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