April 2018 — Clinical Pathology

By MCL Education • April 10, 2018

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A 71-year-old female presented with recent onset severe epistaxis and generalized ecchymoses, without antecedent trauma over the prior 2 to 3 weeks. For the severe epistaxis, she required nasal packing and received a platelet transfusion. She had no prior history of bruising or bleeding. Laboratory results: Hb 12.3 g/dL, Platelet count 245 x 10⁹ /L, PT 9.2s (RR: 8.4-12s), INR 0.9, APTT 27s (RR:21-33s), Thrombin time 19s (RR: 16-25s), PFA Collagen-Epi >265s (RR 70-165s), PFA Collagen-ADP 152s (RR 50-115s), Factor VIII activity 174% (RR 55-205%), VWF Antigen 170% (RR 55-200%), Ristocetin Cofactor 192% (RR 55-200%), and normal Factor XIII qualitative assay. Her platelet aggregation studies were as follows:

	Jose Jara Aguirre, M.D. Resident, Anatomic and Clinical Pathology Mayo Clinic
	Aneel Ashrani, M.D. Consultant, Hematology Mayo Clinic Assistant Professor of Laboratory Medicine and Pathology Mayo Clinic College of Medicine

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