aPTT: activated partial thromboplastin time; CBC: complete blood count; NSAID: nonsteroidal antiinflammatory drug; PT: prothrombin time; SSRI: selective serotonin reuptake inhibitor; VWD: von Willebrand disease.
* The ISTH-BAT delineates and quantifies personal bleeding history and responses to bleeding challenges. A calculator is available at bleedingscore.certe.nl. Cutoffs vary by age and sex, since bleeding challenges are more common in older individuals (surgery, dental procedures) and females (menses and pregnancy). A score ≥4 suggests a possible bleeding disorder; often individuals with bleeding disorders have scores of ≥10.
¶ The aPTT can be normal with mild factor IX or factor XI deficiency. Factor IX and XI activity testing is most relevant in individuals with a positive family history of bleeding (for factor IX, especially in males; for factor XI, especially for those with Ashkenazi Jewish ancestry) and a very high ISTH-BAT score and/or joint and soft tissue bleeding; it may be omitted in individuals with less-severe bleeding history or those in whom other diagnoses seem more likely. Refer to UpToDate topics on bleeding disorders and coagulation testing for details of the likely diagnoses and subsequent testing.
Δ Genetic testing can be done simultaneously with other testing or sequentially, depending on clinical situation and local practices. A hemostasis genetic panel is often used. Refer to UpToDate topics on heritable platelet disorders for listings of specific disorders and genes.Do you want to add Medilib to your home screen?