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Shortened activated partial thromboplastin time: causes and management.
Giuseppe Lippi1, Gian Luca Salvagno, Luigi Ippolito
1Dipartimento di Patologia e Medicina di Laboratorio, Azienda Ospedaliero-Universitaria di Parma, Italy. glippi@ao.pr.it <glippi@ao.pr.it>
Summary
Shortened activated partial thromboplastin time (APTT) results, often overlooked, may indicate significant health risks like cancer or clotting. Laboratories should investigate confirmed short APTT values to rule out preanalytical issues and assess potential clinical conditions.
Area of Science:
- Clinical Chemistry
- Hematology
- Coagulation Science
Background:
- Activated partial thromboplastin time (APTT) traditionally assesses coagulation cascade function as a loss-of-function indicator.
- Shortened APTT results have historically been disregarded or attributed to preanalytical errors.
- Emerging clinical and technical insights necessitate a re-evaluation of shortened APTT significance.
Purpose of the Study:
- To highlight the clinical relevance of shortened APTT results beyond preanalytical issues.
- To encourage investigation into the potential causes and implications of consistently short APTT values.
- To advocate for improved postanalytical laboratory guidance regarding shortened APTT.
Main Methods:
- Review of historical laboratory practices concerning APTT interpretation.
- Discussion of potential preanalytical factors leading to artifactually shortened APTT.
- Exploration of clinical conditions associated with confirmed shortened APTT.
Main Results:
- Shortened APTT, after ruling out preanalytical errors, may be linked to increased risks of thromboembolism, cancer, myocardial infarction, thyroid disorders, diabetes, and pregnancy.
- No definitive consensus exists on the exact origin of shortened APTT.
- Postanalytical commentary on laboratory reports is recommended for confirmed short APTT findings.
Conclusions:
- Shortened APTT results warrant careful consideration and investigation, not dismissal.
- Systematic confirmation of short APTT values should prompt further laboratory assessment.
- Enhanced laboratory reporting can improve clinical awareness and management of conditions associated with shortened APTT.
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