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Ask Dr. Yogindra Vasavada Your Own Question

Dr. Yogindra Vasavada
Dr. Yogindra Vasavada, Pediatrician
Category: Pediatrics
Satisfied Customers: 2678
Experience:  M.D.(ped) passed at first attempt, in practice continuously for last 37 years. Certi. in Comp
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My son has an elevated PT, INR and PTT and a decrease in Fibrinogen levels. PT 17.

Customer Question

My son has an elevated PT, INR and PTT and a decrease in Fibrinogen levels.
PT 17.7 sec (11-14 range)
INR 1.5 (.9-1.1 normal range)
PTT 49 (26-35.5 normal range)
Fibrinogen Level 162 (212-470)
I know these values are barley elevated. Is this something to worry about - what % of increase would indicate a problem? What could this indicate?
Submitted: 3 years ago.
Category: Pediatrics
Expert:  Dr. Yogindra Vasavada replied 3 years ago.

Dr. Yogindra Vasavada :

Hello, It would depend on clinical history of easy bruising and excessive bleeding from minor cuts, Please state the bleeding time and clotting time results. Hypofibrinogenemia could be congenital or due to some liver diseases.

Customer:

PT 17.7 sec (11-14 normal range) INR 1.5 (.9-1.1 normal range) PTT 49 (26-35.5 normal range) Fibrinogen Level 162 (212-470 normal rage). These were the only bleeding time test run - He also had MCV 87 (70-86 normal range) and AST of 86 (20-60 normal range) all other WBC - RBC _ Platelets etc. were all normal

Customer:

He has easy bruising and terrible bloody noses.

Customer:

very tired, pale, leg pain (knee) , bloody noses and LUQ pain that brought him to the Dr.

Dr. Yogindra Vasavada :

That would indicate clinical tendency to bleed and he needs evaluation. Some times due to low fibrinogen activity, thrombosis also can occur in vessels.

Customer:

okay, I thought I should as well. But his Dr. wanted to watch and see what happens in a month.

Dr. Yogindra Vasavada :

Please get bleeding time and clotting time specifically tested. He may be put on vitamin c 125 - 250 mg daily dose.

Customer:

Thank you. XXXXX didn't want to overreact since they were not that elevated. Do you think they are elevated enough to be concerning?

Dr. Yogindra Vasavada :

With clinical symptoms, one should be concerned. Level itself is not material, the quality of fibrinogen may be poor (dysfibrinogenemia).

Customer:

Thank you very much. I will insist on a referal.

Dr. Yogindra Vasavada, Pediatrician
Category: Pediatrics
Satisfied Customers: 2678
Experience: M.D.(ped) passed at first attempt, in practice continuously for last 37 years. Certi. in Comp
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