ROBERT B. FRANCIS JR., M.D.
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To the editor: The statement by Drs. Suchman and Griner (1) that "normal APTT [activated partial thromboplastin time] and PT [prothrombin time] results essentially rule out a significant coagulation defect" (page 814) is not correct. Both factor XIII deficiency and alpha-2-antiplasmin deficiency produce severe bleeding without causing abnormalities in the PT and APTT. Failure to detect these rare but serious bleeding diatheses may result in ineffective or inappropriate therapy. The use of the platelet count and bleeding time is mentioned only in passing. The importance of these two tests in the evaluation of the patient with bleeding is inestimable and
FRANCIS RB. The Activated Partial Thromboplastin Time. Ann Intern Med. ;105:626–627. doi: 10.7326/0003-4819-105-4-626_2
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Published: Ann Intern Med. 1986;105(4):626-627.
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