Mixing study
Mixing Study is a medical diagnostic test used to identify the cause of prolonged Prothrombin Time (PT) or Activated Partial Thromboplastin Time (aPTT) in a patient. It is often used to differentiate between a factor deficiency and an inhibitor as the cause of the prolonged clotting time.
Procedure
The mixing study involves mixing the patient's plasma with normal plasma. If the clotting time corrects (i.e., returns to normal), this indicates a factor deficiency. If the clotting time does not correct, this suggests the presence of an inhibitor.
Factor Deficiency
A Factor Deficiency is a condition where one or more of the clotting factors in the blood are deficient or dysfunctional. This can lead to prolonged clotting times and increased risk of bleeding. Factor deficiencies can be congenital (present from birth) or acquired (developed later in life).
Inhibitor
An Inhibitor in this context refers to an antibody that the body produces against one of its own clotting factors. This can lead to prolonged clotting times and increased risk of bleeding. Inhibitors can be caused by a variety of conditions, including autoimmune diseases, certain medications, and some types of cancer.
Indications
A mixing study may be indicated in patients with unexplained prolonged PT or aPTT, especially if there is a suspicion of a bleeding disorder. It may also be used to monitor the effectiveness of treatment in patients with known factor deficiencies or inhibitors.
Limitations
While a mixing study can help identify the presence of a factor deficiency or inhibitor, it cannot determine which specific factor is deficient or which specific inhibitor is present. Further testing is usually required to make these determinations.
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Contributors: Prab R. Tumpati, MD