4th March 2024

A 45-year-old female presents to his GP with recurrent epistaxis

A 45-year-old female presents to his GP with recurrent epistaxis. She has experienced menorrhagia, which was put down to dysfunctional uterine bleeding after a normal USS of her uterus and ovaries. She reported prolonged bleeding following two tooth extractions several years ago. Blood tests show a normal PT with a mildly prolonged aPTT that corrects on mixing studies. Bleeding time was prolonged. Ristocetin cofactor levels were reduced. A full blood count was normal.

Which clotting factors are likely to be reduced in this patient’s condition?

Select the SINGLE most appropriate option from the list below. Select ONE option only.