What is my blood report for red and purple dots in the body showing?

Question

Hello doctor,

I recently received my blood test results and would like some clarification. I also have clusters of red and purple spots on my body and get winded easily. Here are the results:

Lupus anticoagulant (LA) panel:

Dilute Prothrombin Time (dPT): 56.2 sec (High; ref 0–55).
dPT Confirm Ratio: 1.16 (Normal; ref 0–1.20).
Thrombin Time: 18.1 sec (Normal; ref 0–20).

Lupus anticoagulant reflex:

PTT to LA: 58.6 sec (High; ref 0–50).
PTT-LA Mix: 55.3 sec (High; ref 0–50).
Hexagonal Phase Phospholipid: 7.7 sec (Normal; ref 0–8).
dRVVT: 46.3 sec (Normal; ref 0–55.1).

Interpretation comment:

No lupus anticoagulant was detected.
PTT-LA results suggest the presence of one or more factor-specific inhibitors (factors VIII, IX, XI, XII, or contact factors).
dRVVT is normal.
dPT is slightly prolonged, but the confirmatory ratio is normal, suggesting a deficiency or specific inhibition of extrinsic pathway factors (VII, X, V, II, or fibrinogen).

Could you please explain what these results mean for my health and what might be causing my easy fatigue and the red/purple spots?

Kindly assist.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

You are having multiple petechiae (red and purple, healing) spots all over the body. You are also getting winded, possibly due to reduced hemoglobin. You were being evaluated for a possible lupus anticoagulant. Specific tests done for lupus anticoagulant, like DRVVT, are normal.

PTT-LA is also another test that is specific for lupus anticoagulant. PTT-LA (partial thromboplastin time - lupus anticoagulant) is prolonged, while DRVVT (Dilute Russell's Viper Venom Time) is normal. In the other section, PT is also abnormal.

The clotting mechanism in our body is divided into extrinsic and intrinsic pathways. Both end with the common pathway and finally clot formation. Totally 13 clotting factors are identified at present. To measure each pathway, specific tests are present. For the intrinsic pathway, Factors 8,9,11,12 are usually evaluated. It is measured through a test called activated partial thromboplastin time (APTT or PTT.

For the extrinsic pathway, Factor 7 is important. The extrinsic pathway is measured by prothrombin time (PT). Along with it, both extrinsic and intrinsic join and form a common pathway, which includes coagulation factors like 10, 5, 2, and fibrinogen.

As both PTT and PT are prolonged, they are possibly suspecting multiple factor deficiencies. It could be multiple or only a common pathway defect, as I mentioned earlier. Not to worry about this report. You are negative for most of the tests, with mild variation in a few tests. This is about your earlier report.

At present, in your latest report, your factor assay shows most of the values near normal limits. Even your PT and APTT are near normal. Possible mild thrombocytosis and leukocytosis could be commonly due to infection. Without an increased RBC count or hemoglobin, I would not suspect polycythemia vera (for which the JAK-2 mutation is being evaluated). Increased neutrophil count usually suggests acute inflammation or infection.

Not to worry about any clotting disorder at present. Low hemoglobin or malnutrition should be causing you to be winded easily. Red and purple dots are usually petechiae spots. Need to rule out any viral infections with superadded bacterial infections. Require more details, about how they started, since when, from which location, and whether it is painful or is it changing colors to comment further.

Revert for any other doubts.

Thank you.