Combined anticoagulant deficiency causing extrahepatic portal venous obstruction: A case report

Table 1 Routine blood tests

Parameter (units)	Day 1	Day 3	Day 5	Day 7	Day 11	Day 14	Day 30
Hemoglobin (g/dL)	4.3	6.8	9.4	9.4	8.2	7.7	9.0
Total leucocyte count (cells/cubic mm)	11370	21700	11500	14400	12600	15000	21600
Differential leucocyte count (neutrophil/Lymphocyte) (%)	90/7	80/10	93/3	83/2	87/8	87/0.6	93/4
Platelet (cells/cubic mm)	60000	60000	52000	60000	100000	220000	100000
Bilirubin (total/direct) (mg/dL)	0.5	2.8/0.6	1.9/0.7	1.2/0.4	1.4/0.4	2.5/0.5	2/0.5
Total protein (g/dL)	-	4.3	4.7	5.0	5.9	5.3	5.2
Albumin (g/dL)	3.1	2.6	2.7	2.6	3.8	3.7	2.7
Globulin (g/dL)	-	1.7	2.0	2.4	2.1	1.6	2.5
ALT (IU/L)	32	60	60	52	42	19	30
AST (IU/L)	58	122	73	64	39	31	53
ALP (IU/L)	65	87	92	89	69	65	64
PT (second)	13.4	14.5	-	12.0	25.0	20.0	16.0
INR	0.95	1.25	-	1.03	0.90	0.80	1.11
Urea (mg/dL)	28	63	36	28	-	-	13
Creatinine (mg/dL)	0.9	0.9	0.8	1.0	-	-	0.4
Sodium (mEq/L)	135	143	147	135	142	-	131
Potassium (mEq/L)	5.5	3.6	3.1	4.3	3.7	-	3.9

ALT: Alanine transaminase; AST: Aspartate transaminase; ALP: Alkaline phosphatase; PT: Prothrombin time; INR: International normalized ratio.

Table 2 Analysis of pleural fluid and ascitic fluid

Parameter (units)	Ascitic fluid	Pleural fluid
Total protein (g/dL)	0.6	0.4
Total albumin (g/dL)	0.3	0.3
Total cell count	150 (neutrophil 60%, lymphocyte 30%, mesothelial cells 10%)	80 (neutrophil 20%, lymphocyte 50%, mesothelial cells 30%)

Table 3 Coagulation profile

Parameter	Observed value	Reference interval
PT	14.5 s	11.0-15.0 s
aPTT	32 s	25-35 s
INR	1.25	0.80-1.20
Thrombin time	17 s	14-19 s
Fibrinogen	283 mg/dL	200-400 mg/dL
D-Dimer	1.30 µFEU/mL	< 0.5 µFEU/mL
Protein C, %	42	70-140
Protein S, %	18	60-150
Antithrombin III, %	62	80-130
Von Willebrand factor, %	100	50-160
Factor V Leiden mutation	Absent	-
Lupus anticoagulant	Negative	-

PT: Prothrombin time; aPTT: Activated partial thromboplastin time; INR: International normalized ratio.