Management of autoimmune factor XIII deficiency in a frail, elderly patient.
Journal
Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis
ISSN: 1473-5733
Titre abrégé: Blood Coagul Fibrinolysis
Pays: England
ID NLM: 9102551
Informations de publication
Date de publication:
01 Sep 2023
01 Sep 2023
Historique:
medline:
18
8
2023
pubmed:
27
3
2023
entrez:
26
3
2023
Statut:
ppublish
Résumé
Autoimmune factor XIII/13 deficiency (aFXIII deficiency) is a rare hemorrhagic disorder, for which typical guideline-directed treatment is aggressive immunosuppressive therapy. Approximately 20% of patients are over 80 years old; however, and optimum management of such patients has not reached consensus. Our elderly patient had massive intramuscular hematoma, and aFXIII deficiency was diagnosed. The patient opted against aggressive immunosuppressive therapy, so he was managed with conservative treatment only. Thorough survey of other correctable causes of bleeding and anemia is also required in similar cases. Our patient's serotonin-norepinephrine reuptake inhibitor use and multivitamin deficiency (vitamin C, B 12 and folic acid) were revealed to be aggravating factors. Fall prevention and muscular stress prevention are also important in elderly patients. Our patient had two relapses of bleeding within 6 months, which were improved spontaneously by bed rest without factor XIII replacement therapy or blood transfusion. Conservative management may be preferred for frail and elderly patients with aFXIII deficiency when they opt against standard therapy.
Identifiants
pubmed: 36966755
doi: 10.1097/MBC.0000000000001202
pii: 00001721-990000000-00062
doi:
Substances chimiques
Factor XIII
9013-56-3
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
408-413Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
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