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Updated: Dec 29, 2025

Comprehensive Analysis of Procoagulant Platelets Exhibiting Features of Necrosis, Apoptosis and Platelet Activation

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Prolonged activated partial thromboplastin time with no clear explanation.

Sigal Nakav¹, Dorit Blickstein^2,3, Pia Raanani^2,3

¹Coagulation and Hemostasis Laboratory.

Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis

|January 29, 2020

Summary

A colon cancer patient had prolonged activated partial thromboplastin time (aPTT) due to a rare acquired prekallikrein deficiency. This condition was identified through laboratory workup and corrected before surgery.

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Area of Science:

Hematology
Oncology
Clinical Biochemistry

Background:

Preoperative evaluation of bleeding risk typically involves aPTT.
Asymptomatic prolonged aPTT can indicate underlying coagulation disorders.

Observation:

A colon cancer patient presented with asymptomatic prolonged aPTT (72-100s), abnormal for the first time.
In vitro mixing studies corrected the aPTT, ruling out factor deficiencies or inhibitors.

Findings:

Further investigations identified a rare acquired prekallikrein deficiency as the cause of prolonged aPTT.
The patient underwent successful surgery after correction with fresh frozen plasma.

Implications:

Highlights the importance of investigating unexplained prolonged aPTT, even when asymptomatic.
Underscores the clinical significance of contact phase protein deficiencies in surgical patients.