# Prolongated Activated Partial Thromboplastin Time (aPTT) in Pediatric Patients before Surgery—Crying Wolf: Lupus (Anticoagulant) Does Not Always Threaten Children

## TL;DR

This paper reviews cases where children have prolonged aPTT before surgery, helping doctors better assess bleeding risks without unnecessary delays.

## Contribution

The paper provides a framework to interpret isolated aPTT prolongation in children, particularly due to antiphospholipid antibodies.

## Key findings

- Prolonged aPTT in children is often not due to serious bleeding risks.
- Antiphospholipid antibodies may cause false positives in aPTT tests.
- Proper interpretation can reduce unnecessary testing and delays in surgery.

## Abstract

A prolonged preoperatory aPTT in children is often the cause of a delay of scheduled surgeries and the repetition of multiple blood tests, with the consequent wasting of resources and significant discomfort for children and parents. The aim of this review is to analyze the situations in which an isolated prolongation of aPTT is found during preoperative evaluation in children, especially when it is due to the presence of antiphospholipid antibodies, providing the readers with the keys to interpret this situation and the possibility to correctly evaluate the hemorrhagic risk of a patient.