Author(s)

Noemí Aguirre¹, Francisca Córdova², Francisca Jaime³, Ximena Fonseca⁴, Pamela Zúñiga⁵

¹Pediatrics Resident, Pontifical Catholic University of Chile, Santiago, Chile.
²School of Medicine, Pontifical Catholic University of Chile, Santiago, Chile.
³Pediatrician, Resident of Pediatric Gastroenterology and Nutrition, Pontifical Catholic University of Chile, Santiago, Chile.
⁴Otorhinolaryngologist, Assistant Professor, Pediatrics Division, Medical School, Pontifical Catholic University of Chile, Santiago, Chile.
⁵Hematologist-Oncologist, Assistant Professor, Pediatrics Division, Medical School, Pontifical Catholic University of Chile, Santiago, Chile.

Introduction: Activated partial thromboplastin time (aPTT) is one of the most used coagulation tests in preoperative evaluation. Incidental detection of a prolonged aPTT is a problem in primary care, in which the general pediatrician should be able to attend its initial management. Objective: To describe final diagnosis of patients with prolonged aPTT in preoperative study. Materials and Methods: This is a descriptive study of patients referred from otorhinolaryngology. Results: Totally, 508 adenoidectomies and/or tonsillectomies were performed in our center, 38 of which referred patients (7.5%) with prolonged aPTT, and 30 of which met inclusion criteria. The median age was 4 years. 56.6% of patients were males. 76.6% of patients normalized aPTT at the second follow-up. Among these, 73.9% showed a normal study, 4.3% ha2d lupus anticoagulant and in 21.7% Von Willebrand disease was detected. Among patients that persisted with prolonged aPTT, 42.8% had coagulant factors deficiency, 28.5% had lupus anticoagulant and in 28.5% of patients a diagnosis could not be achieved with the tests used in the present study. Multivariate analysis did not show correlation between final diagnosis and the variables measured. Conclusion: The presence of a prolonged aPTT in children under preoperative study is due to a pre-analytic factor in the majority of cases or to the presence of lupus anticoagulant, normalizing values on follow-up. We suggest that a new aPTT be performed on these patients, and only those that persist altered or present a symptoms and family history of coagulation disorders be referred to hematology.

aPTT, Preoperative Study, Tonsillectomy, Adenoidectomy, Coagulopathy

Aguirre, N. , Córdova, F. , Jaime, F. , Fonseca, X. and Zúñiga, P. (2015) Final Diagnosis of Pediatric Patients with Prolonged in Activated Partial Thromboplastin Time Preoperative Study. International Journal of Otolaryngology and Head & Neck Surgery, 4, 241-247. doi: 10.4236/ijohns.2015.43041.