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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Pregnant. Test showed high ESR level. Should I go for APTT and dRVVT. Any complication?

Answered by
Dr. Sujoy Khan

Allergist and Immunologist

Practicing since :1999

Answered : 584 Questions

Posted on Wed, 23 Jan 2013 in Pregnancy
Question: Hi. I'm 34 years old and 10 weeks pregnant. my OB asked me to take several test. everyting is normal except for ESR which is 56. the normal value for my age is 0-20mm/hr. what does it mean? I also have KCT which is 100 result and 76 sec control, APTT 30 results and 25 sec control and DRVVT 39 and 36 sec control. hope you can initial interpret this since I will be seeing my doctor next week. I'm really worried since ERP is high and I don't know how to interpret the KCT, APTT and DRVVT.
Answered by Dr. Sujoy Khan 2 hours later
Welcome to Healthcare Magic and thank you for writing to us.

As you know you have lupus that is a multi-system connective tissue disorder and quite rightly your OG doctor has requested those tests.
KCT, APTT and dRVVT are tests to find out if you have 'lupus anticoagulant' that is a risk factor for blood clots to appear in patients with lupus.
Another test is the anticardiolipin (antiphospholipid) antibody test which looks for IgG and IgM antibodies against phospholipid antigens. Usually if this test is positive, the lupus anticoagulant is requested to see what your risks are of having clots and threatening the pregnancy.

As you have rightly noted, the ESR is high which can be high in pregnancy as various clotting proteins increase in circulation giving a high ESR (erythrocyte sedimentation rate). This test is also high in patients with lupus when the disease is active. So it is important to see what the previous results were.
KCT 100 (76) is high, APTT slightly high, dRVVT also slightly high that would mean the lupus anticoagulant is present but has not altered the clotting results significantly. Please discuss this with your Rheumatologist who is looking after you.

There are several treatment options for women with lupus during pregnancy including preventive strategies such as starting aspirin and getting regular ultrasound checks on the baby to make sure all is well.

I hope this was helpful.
Best Wishes.
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