Skip to content
Licensed Unlicensed Requires Authentication Published by De Gruyter January 28, 2021

The activated partial thromboplastin time may not reveal even severe fibrinogen deficiency

Anders Abildgaard ORCID logo and Anne-Mette Hvas

Corresponding author: Anders Abildgaard, MD, PhD, Department of Clinical Biochemistry, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200Aarhus N, Denmark, E-mail:

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.


1. Higgins, RA, Kitchen, S, Chen, D. Hemostasis. Tietz textbook of clinical chemistry and molecular diagnostics. New York: Elsevier; 2018.10.1016/B978-1-4160-6164-9.00059-7Search in Google Scholar

2. Levy, JH, Goodnough, LT. How I use fibrinogen replacement therapy in acquired bleeding. Blood 2015;125:1387–93. in Google Scholar PubMed

3. Palla, R, Peyvandi, F, Shapiro, AD. Rare bleeding disorders: diagnosis and treatment. Blood 2015;125:2052–61. in Google Scholar PubMed

4. Dempfle, CE, Kalsch, T, Elmas, E, Suvajac, N, Lucke, T, Munch, E, et al.. Impact of fibrinogen concentration in severely ill patients on mechanical properties of whole blood clots. Blood Coagul Fibrinolysis 2008;19:765–70. in Google Scholar PubMed

5. Nielsen, VG, Cohen, BM, Cohen, E. Effects of coagulation factor deficiency on plasma coagulation kinetics determined via thrombelastography: critical roles of fibrinogen and factors II, VII, X and XII. Acta Anaesthesiol Scand 2005;49:222–31. in Google Scholar PubMed

6. Fries, D, Innerhofer, P, Reif, C, Streif, W, Klingler, A, Schobersberger, W, et al.. The effect of fibrinogen substitution on reversal of dilutional coagulopathy: an in vitro model. Anesth Analg 2006;102:347–51. in Google Scholar PubMed

7. CLSI. H47-A2 one-stage prothrombin time (PT) test and activated partial thromboplastin time (APPT) test; approved guideline, 2nd ed. Wayne: Clinical and Laboratory Standards Institute; 2008.Search in Google Scholar

8. Adcock, DM, Favaloro, EJ, Lippi, G. Critical pre-examination variables in the hemostasis laboratory and their quality indicators. Clin Biochem 2016;49:1315–20. in Google Scholar PubMed

9. Tripodi, A, Mannucci, PM. The coagulopathy of chronic liver disease. N Engl J Med 2011;365:147–56.10.1056/NEJMra1011170Search in Google Scholar

10. Papageorgiou, C, Jourdi, G, Adjambri, E, Walborn, A, Patel, P, Fareed, J, et al.. Disseminated intravascular coagulation: an update on pathogenesis, diagnosis, and therapeutic strategies. Clin Appl Thromb Hemost 2018;24:8S–28S. in Google Scholar PubMed PubMed Central

Received: 2020-10-31
Accepted: 2021-01-14
Published Online: 2021-01-28
Published in Print: 2021-06-25

© 2021 Walter de Gruyter GmbH, Berlin/Boston

Scroll Up Arrow