Bleeding History in a Child Undergoing Surgery

Spero R. Cataland, MD, and Eric H. Kraut, MD

Ohio State University


IV. DIFFERENTIAL DIAGNOSIS

Laboratory Test Results

Test Patient Normal Range
White blood cell count 6,000/μL 4,500 – 15,000/μL
Hemoglobin 14 g/dL 11.7 – 15.5 g/dL
Platelet count 250,000/μL 150,000 – 400,000/μL
Peripheral smear evaluation Normal-appearing platelet morphology, no abnormal white blood cells, normal shape and distribution of red blood cells  
Prothrombin Time (PT) 13.5 sec 12.3 – 14.5 sec
Partial Thromboplastin Time (PTT) 50 sec 24 – 34 sec
PTT 1:1 mixing study 30 sec 24 – 34 sec
Ristocetin co-factor activity 85% 40% – 200%
von Willebrand antigen 75% 50% – 180%

Given these laboratory results, which of the following are possible diagnoses in this patient?

Von Willebrand disease

Hemophilia A

Hemophilia B

Glanzmann’s thrombasthenia

Platelet storage pool disorder

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