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Can My Fiancee's Immigration Be Stopped Due To An Episode Of Low Prothrombin?

Posted on Sat, 5 May 2012

Question: sorry this is a bit long.

My fiancee in the Philippines had extra pulmonary TB. I funded her treatment for 6 months and she is now cured. WHILST IN HOSPITAL SHE WAS GIVEN FRESH FROZEN PLASMA TRANSFUSION AS SHE WAS TO UNDERGO A THORACENTESIS. SHE HAD A PLEURAL EFFUSION. THE NEW ZEALAND IMMIGRATION MEDICAL ADVISOR HAS ASKED FOR A REPORT ON THE TRANSFUSION. HER PT WAS 0.06. SHE TOOK VITAMIN B12 AS WELL AS HER TB MEDS. SHE IS NOW A PICTURE OF HEALTH AND HAS GAINED 8KG. I THINK HER DERANGED PT WAS DUE TO ILLNESS AND MALNOURIHMENT. DO YOU THINK THE PT ISSUE IS SIGNIFICANT? SHE HAS SUBSEQUENTLY HAD FULL IMMIGRATION MEDICALS AND THIS INCLUDED BLOOD TESTS AND NO MENTION OF DERANGED PT WAS MADE SO THE ONE OFF ISSUE IS NOW OVER 6 MONTHS OLD.

Answered by Dr. Sapan J. Pandya (22 minutes later)

Hi! XXXXXXX
I believe that her six months old, one-time, low Prothrombin Time is not of much significance. Especially if she is in good health now.
As you have rightly pointed out low Prothrombin Time would have been by malnutrition (low protein state).
But to reconfirm,
Was the Prothrombin Time only 0.06 seconds? Or is it INR (International Normalized Ratio) you are talking about?
Was APTT done at that time?
Were SGOT & SGPT done at that time?
Low Prothrombin Time leads to a hypercoaguable state where the blood may clot anytime. Your fiancee was lucky to get good medical care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sapan J. Pandya (47 minutes later)

She had the thoracentesis without any prblems. The report says she was given less than 1 unit of plasma because she had an allergic reaction (itch and fever) so it was stopped imediately. The prothombin level was 0.6 NOT 0.06 as I wrongly stated before. Sadly this site does not allow me to attach the report. It is described in the report as PT.

Answered by Dr. Sapan J. Pandya (6 hours later)

Hi XXXXXXX

Thanks for the reply

This site does allow you to scan your report and send via attachment to an email. You may send the same at YYYY@YYYY with the SUB:ATTN Dr. Sapan J. Pandya.

As such for the query you need not send the report.
I would advise you not to worry about that low Prothrombin Time incident.

Hope this answers your query.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sapan J. Pandya (5 days later)

I noticed my fiancees prognosis remained fair even after treatment and negative culture tests and stable x-ray for 5 month. i asked the pulmonologist why this was and they said........"Although your fiancée has completed her treatment and her chest radiographs show stability, the prognosis is still fair because there are residual abnormalities in her chest radiograph that has weakened her lung’s health which would require follow-up when she gets to New Zealand. If during follow-ups her chest radiographs remain stable in 2 years or more, then the prognosis will definitely change from fair to good." Do you think this will stop her comming to New Zealand?

Answered by Dr. Sapan J. Pandya (10 minutes later)

Welcome Back XXXXXXX
No, I believe that this minor hitch should not stop her from returning to New Zealand.
With Pulmonary Rehabilitation (Lung Physiotherapy) she will recover whatever function she has lost.
When it is in black & white, everybody want to err on the side of caution. So the doctor would advise more caution than necessary

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sapan J. Pandya (2 hours later)

I emailed you the pulmonologists report. Did you see it?

Thank you for your help. This is a stressful time for us. NZ is a very picky country about immigration.

Thank you for your understanding

Follow up: Dr. Sapan J. Pandya (23 hours later)

The NZ Immigration have asked for a certificate. They say........ "The TB is now 'clear', therefore we can waive this.

However the report relating to the platelet transfusion is inconclusive. We have tried talking to a panel doctor regarding what the report means, and also tried 'googling' the result, however we cannot figure if the treatment was completed or not? but it basically states that Ms. Tating had a reaction during her transfusion, therefore it was stopped.

From what we can find, they are completely unrelated. However the information we have found states there can be further issues such as the fact that the lung must be re-inflated etc, Therefore, could you ask Ms. Tating to provide a more comprehensive report, including the prognosis, any further treatment required etc? "

So thanks for your help but as I said NZ Immigration is way over the top on most things.

Answered by Dr. Sapan J. Pandya (20 minutes later)

Hi,

There is no relation between Tuberculosis treatment and Platelet Transfusion.

I think they were saying about certain transfusion reaction during platelet transfusion, hence halted it. This can happen often because of mismatch or platelets not being stored properly.

It should not be an objection for immigration at all.

Thanks.

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar