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The partial thromboplastin time (PTT), also known as the activated partial thromboplastin time (aPTT or APTT), is a blood test that characterizes coagulation of the blood.A historical name for this measure is the Kaolin-cephalin clotting time (KCCT), [1] reflecting kaolin and cephalin as materials historically used in the test.
The basic purpose of these tests is to determine the cause of prolongation of Prothrombin Time (PT), Partial Thromboplastin Time, or sometimes of thrombin time (TT). Mixing studies take advantage of the fact that factor levels that are 50 percent of normal should give a normal Prothrombin time (PT) or Partial thromboplastin time (PTT) result. [2]
PT measures the following coagulation factors: I (fibrinogen), II (prothrombin), V (proaccelerin), VII (proconvertin), and X (Stuart–Prower factor). PT is often used in conjunction with the activated partial thromboplastin time (aPTT) which measures the intrinsic pathway and common pathway of coagulation.
This test is repeated with pooled plasma from normal patients. The difference in time between the test and the 'normal' indicates an abnormality in the conversion of fibrinogen (a soluble protein) to fibrin, an insoluble protein. [2] The thrombin time compares the rate of clot formation to that of a sample of normal pooled plasma.
Clotting time is a general term for the time required for a sample of blood to form a clot, or, in medical terms, coagulate.The term "clotting time" is often used when referring to tests such as the prothrombin time (PT), activated partial thromboplastin time (aPTT or PTT), activated clotting time (ACT), thrombin time (TT), or Reptilase time.
A mixing test is generally in the initial workup of a prolonged aPTT. In a mixing test, patient plasma is mixed with normal pooled plasma and the clotting is reassessed. If a clotting inhibitor such as a lupus anticoagulant is present, the inhibitor will interact with the normal pooled plasma and the clotting time will generally remain abnormal.
Bleeding time may be affected by platelet function, certain vascular disorders and von Willebrand Disease—not by other coagulation factors such as haemophilia.Diseases that may cause prolonged bleeding time include thrombocytopenia, disseminated intravascular coagulation (DIC), Bernard-Soulier disease, and Glanzmann's thrombasthenia.
Typical is a discordance between the prolonged prothrombin time (PT) and normal levels for the activated partial thromboplastin time (APTT). [1] FVII levels are <10IU/dl in homozygous individuals, and between 20-60 in heterozygous carriers. [2] The FCVII: C assay supports the diagnosis. [1] The FVII gene (F7) is found on chromosome 13q34. [1]