Use this case to answer the following questions:
A 5-year-old boy visits his primary care physician after an accident on his bike.It was his first accident, and he fell on his knees.His mother noticed severe swelling in his knees and elbows, but thought that it was from the accident.She placed an ice pack on the affected areas and put him to rest.After a few days, the swelling had not improved, so she made an appointment to see his pediatrician.The physician asks him a few questions about the accident and then proceeds to perform a physical examination.The physician notes small hematomas on his elbows and knees and also on his upper torso.He draws blood, and the results are shown below. PT: 12.2 sec (RR: 11.3-12.8 sec)
INR: 1.12
APTT: 72 sec (RR: 23-32 sec)
Platelet aggregation studies: normal aggregation with all agonists
The physician admits him to the area hospital.
-What disorder is the patient most likely suffering from?

Question

Use this case to answer the following questions: 
A 5-year-old boy visits his primary care physician after an accident on his bike.It was his first accident, and he fell on his knees.His mother noticed severe swelling in his knees and elbows, but thought that it was from the accident.She placed an ice pack on the affected areas and put him to rest.After a few days, the swelling had not improved, so she made an appointment to see his pediatrician.The physician asks him a few questions about the accident and then proceeds to perform a physical examination.The physician notes small hematomas on his elbows and knees and also on his upper torso.He draws blood, and the results are shown below. PT: 12.2 sec (RR: 11.3-12.8 sec)
INR: 1.12
APTT: 72 sec (RR: 23-32 sec)
Platelet aggregation studies: normal aggregation with all agonists
The physician admits him to the area hospital.
-What disorder is the patient most likely suffering from?

Quizplus · Accepted Answer

The patient is presenting with hematomas after a minor injury and prolonged APTT, which could indicate a possible hemophilia. Platelet aggregation studies are normal, which rules out von Willebrand's disease. DIC typically presents with increased coagulation, not prolonged APTT. Lupus anticoagulant is a possibility, but the clinical presentation suggests hemophilia as the more likely diagnosis. The best choice would be to perform factor VIII and IX assays to confirm or rule out hemophilia.

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