List five (5) likely causes for the following coagulation profile:
Test |
Value |
Normal Range |
PT* |
35.4 sec |
(12.0 – 15.0) |
INR* |
3.5 |
(0.8 – 1.1) |
APTT* |
>170.0 sec |
(25.0 – 37.0) |
FIBRINOGEN* |
0.9 G/L |
(2.20 – 4.30) |
• DIC
• Primary fibrinolysis
• Dilutional coagulopathy from massive transfusion
• Post thrombolysis
• Snake bite
Everything is wrong in this coags panel. Both the intrinsic and extrinsic pathways have become deranged, and the fibrinogen is depleted. The latter is a clue that some sort of consumption coagulopathy is taking place.
Again, I reproduce this table, from this chapter:
Normal PT | Raised PT | |
Normal APTT |
|
Extrinsic pathway failure
|
Raised APTT |
Intrinsic pathway failure
|
Intrinsic and extrinsic pathway failure
|
So, the differentials for this sort of pan-coagulopathy are
Hunt, Beverley J. "Bleeding and coagulopathies in critical care." New England Journal of Medicine 370.9 (2014): 847-859.