A child underwent tonsillectomy at the age of 6 years with no complications. He underwent preoperative screening for bleeding at the age of 12 years for elective laparotomy and found to have prolonged PTT but normal PT there is no family history of bleeding. The patient is likely to have:
|A||Acquired vitamin K deficiency|
|B||Acquired liver disease|
|C||Factor XII deficiency|
|D||Mild hemophilia A|
Factor XII deficiency
In vitamin K deficiency or liver disease both PT and PTT will be prolonged. In hemophilia A and factor XII deficiency PTT will be prolonged and PT will be normal. Factor XII deficiency is not associated with excessive bleeding even after major surgery (in spite of prolonged PTT) so factor XII deficiency should be considered if PTT is prolonged with no history of bleeding.