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Rare Prekallikrein Deficiency Identified During Workup of Isolated Prolonged Activated Partial Thromboplastin Time

Jennifer S. Woo, Jennifer Tseng, Irene M. Kang, Lefan Zhuang, Ryan Jackson, Olga V. Danilova and Azra Borogovac
Ochsner Journal October 2024, DOI: https://doi.org/10.31486/toj.24.0046

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Figures

  • Figure.
    Figure.

    Diagnostic algorithm for the contemporary workup of an isolated prolonged activated partial thromboplastin time (aPTT). This algorithm depicts factor activity testing, lupus anticoagulant (LA) testing, and the mixing study test performed concurrently.3,5,11,12 HMWK, high molecular weight kininogen.

Tables

  • Table.

    Coagulation Workup for Isolated Prolonged Activated Partial Thromboplastin Time

    Laboratory TestResultReference Range
    Activated partial thromboplastin time, seconds121.325.4-34.3
    Prothrombin time, seconds12.512.7-14.5
    Thrombin time, seconds15.614-21
    Activated partial thromboplastin time mixing study, interpretationCorrection of activated partial thromboplastin time into reference rangeN/A
    Factor VIII activity, %15856-140
    Factor IX activity, %13450-150
    Factor XI activity, %168.550-150
    Factor XII activity, %110.250-150
    Prekallikrein, %<1555-207
    High molecular weight kininogen, %17765-135
    Dilute Russell viper venom time, interpretationNegativeNegative
    Lupus anticoagulant–sensitive partial thromboplastin time with hexagonal phospholipid neutralization, interpretationNegativeNegative
    Anticardiolipin IgG, GPL U/mL<90-14
    Anticardiolipin IgM, MPL U/mL<90-12
    Beta-2 glycoprotein 1 antibody IgG, GP1 IgG units<90-20
    Beta-2 glycoprotein 1 antibody IgM, GP1 IgM units<90-32

    • IgG, immunoglobulin G; IgM, immunoglobulin M; N/A, not applicable.

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