In addition to its essential role in hemostasis, fxiii is involved in maintenance of pregnancy, wound healing, and angiogenesis. Unlike elevated ddimers, acquired factor xiii deficiency in an activated clotting system can cause severe and fatal bleeding. Factor xiii deficiency is an extremely rare inherited blood disorder. Factor xiii deficiency occurs exceedingly rarely, causing a severe bleeding tendency. If you have problems viewing pdf files, download the latest version of adobe reader. It is caused when a persons body doesnt produce enough of protein in the blood factor xi that helps blood clot or the factor xi doesnt work properly. Factor v and factor viii deficiency rare bleeding disorders. Factor xiii deficiency is an extremely rare inherited blood disorder characterized by abnormal blood clotting that may result in abnormal bleeding. It results in excessive or prolonged bleeding after an injury or surgery. Factor xiii deficiency, rare bleeding disorder, laboratory diagnosis the role of factor xiii in hemostasis coagulation factor xiii fxiii is a zymogen that acts as a multifunctional protein. Factor xiii deficiency, also known as fibrin stabilizing deficiency, is a rare genetic bleeding disorder. Most are due to mutations in the a subunit gene located on chromosome 6p25p24. Factor xiii deficiency is normally treated with fresh frozen plasma, cryoprecipitate or. Factor xi fxi deficiency, also known as haemophilia c, is an inherited bleeding disorder.
Acquired factor xiii deficiency acquired f deficiency. Fxiii is also known as fibrinstabilizing factor and is responsible for crosslinking of the fibrin polymer. Congenital fxiii deficiency is a rare bleeding disorder, with an. Pdf factor xiii fxiii is unique among clotting factors for a number of reasons. The dose is repeated every 48 to 72 hours depending on measured factor xi levels. This is different than just factor v deficiency or factor viii deficiency hemophilia a.
Even though the initial clot forms and bleeding stops, the clot will eventually break down. Factor xiii deficiency nord national organization for. Patients with acute myelocytic leukemia and all patients receiving prolonged. Severe congenital factor xiii subunit a deficiency is an ex tremely rare, autosomal recessive disorders affecting in the range of 2,000,0005,000,000 people. Avoidance of trauma and nonsteroidal antiinflammatory drugs nsaids is. The body produces less factor xiii than it should, or the factor xiii is not working properly, therefore the clotting reaction is blocked prematurely and the blood clot does not form. Clotting factors are specialized proteins that are essential for the blood to clot properly. If the condition is not treated, affected individuals may have episodes of excessive and. Factor xi deficiency haemophilia foundation australia.
However, severe fxiii deficiency may result in lifethreatening bleeding. Signs and symptoms occur as the result of a deficiency in the blood clotting factor, which is responsible for stabilizing the formation of a blood clot. Factor xiii deficiency is an inherited bleeding disorder. Specifically, individuals with factor xiii deficiency form blood clots like. Combined factor v 5 and factor viii 8 deficiency is an inherited bleeding disorder that is caused by low levels of factors v and viii. Differently from all other congenital haemostatic protein deficiencies, in congenital fxiii deficiency typical coagulation screening tests and platelet function tests are. By crosslinking fibrin chains and alpha 2 plasmin inhibitor to fibrin, fxiiia mechanically stabilizes fibrin and protects it from fibrinolysis. Treatment often involves prophylaxis with fxiii concentrate and is especially important in preventing intracranial hemorrhage ich and maintaining pregnancy in women of childbearing age. Bleeding ranges from mild to severe depending on how severe the deficiency is. Factor xiii deficiency genetics home reference nih.
List of factor xiii deficiency medications 3 compared. Acquired factor xiii deficiency can be caused by disorders including an inflammatory disease of the liver called hepatitis, scarring of the liver cirrhosis, inflammatory bowel disease, overwhelming bacterial infections sepsis, and several types of cancer. These very rare factor deficiencies, from factor xiii deficiency, the rarest, occurring in an estimated 1 out of 5 million people, to factor xi deficiency, occurring in about 1 out of 100,000, were all discovered and identified in the 20 th century. Factor ii, also known as prothrombin, is a protein made in.
Factor xiii deficiency leads to abnormal and prolonged bleeding due to ineffective clot formation. Learn what causes this deficiency and how to treat it. Congenital factor xiii deficiency rare bleeding disorders. In iran, a middle eastern country with a high rate of. Selected individuals with partial factor xi deficiency may have bleeding at this level and may require higher levels. Fibrinolysis and the control of blood coagulation ncbi.
For language access assistance, contact the ncats public information officer. Factor xiii deficiency is an inherited blood clotting disorder that affects females as well as males. Recently, we experienced a case of hemorrhagicacquired factor xiii deficiency that occurred during treatment with the il6 inhibitor tocilizumab for rheumatoid arthritis. Causes of acquired deficiency include immunemediated inhibition, as well as nonimmune fxiii hyperconsumption or hyposynthesis.
Board 1979 described genetic polymorphism of the a subunits. Xiiia is an enzyme of the blood coagulation system that crosslinks fibrin. Genetic and rare diseases information center gard po box 8126, gaithersburg, md 208988126 tollfree. Factor xiii deficiency is a rare, genetic bleeding disorder characterized by deficiency of clotting factor xiii. Fxiiia plays a major role in clot formation and consolidation by crosslinking fibrin to produce the structural framework of a thrombus that is able to withstand. Coagulation factor xiii gene, protein structure and function coagulation factor xiii fxiii is a. Factor xiii deficiency is a congenital disorder that is inherited as an autosomal recessive trait and is associated with a variable bleeding tendency acquired factor xiii deficiency is associated with liver failure, inflammatory bowel disease, leukemia, disseminated intravascular coagulation, henochschonlein purpura. Fibrin is crosslinked at lysine residues by factor xiiia and forms.
Partial thromboplastin time to check how long it takes for blood to clotmixing study, a special ptt test to confirm factor xii deficiency. Congenital factor xiii deficiency is very rare, affecting only 1 in 2 million people about 100125 people in the us. Xiiia deficiency formerly type ii f deficiency and xiiib. Evaluation of neutron reactions on iron isotopes for cielo and. Factor xiii is a protein that stabilizes blood clots factor xiii f xiii or factor is one of the 12 clotting factors that are labeled factors i to xiii factors v. Factor xiii deficiency is a rare, genetic bleeding disorder characterized by. Factor xiii deficiency is a rare bleeding disorder. Curiously, congenital deficiency of plasminogen is not associated with. People with congenital or inherited factor xiii deficiency are born with low levels of factor xiii in the blood.
However, up to onethird of people with factor vii deficiency never have any bleeding problems. All therapies now include various types of postinduction consolidation or intensification regimens, cns. Factor xiii deficiency canadian hemophilia society, 2001 explains how factor xiii deficiency is passed on, what causes it, diagnosis, symptoms, treatments, preventing and treating bleeds, issues relating to women, pregnancy and fertility, lifestyle and vaccinations. Factor xiii deficiency an overview sciencedirect topics. Factor concentrates for the treatment of factor xiii deficiency. Deficiency of xiii worsens clot stability and increases bleeding tendency. Factor xiii deficiency fxiiid is a rare bleeding disorder with an estimated prevalence of 1 in 2million population worldwide. Hemostasis anatomy and physiology ii lumen learning. Acquired factor xiii fxiii deficiency is a common disease and seldom causes bleeding. Xiii, factor xiii deficiency, fibrin stabilizing factor.
Other factor deficiencies national hemophilia foundation. Fxii appears to be not essential for blood clotting, as individuals with this condition are usually asymptomatic and form blood clots in vivo. Factor xiii deficiency is perhaps the rarest of all factor deficiencies. Figure 1 shows what can happen when a carrier of the defective gene has a child with another carrier.
Acquired factor xiii deficiency can result when the body produces autoantibodies inhibitors that attack factor xiii. Factor xiii deficiency congenital fxiii deficiency can be due to defects in either fxiii. Fxii deficiency tends to be identified during presurgical. In addition, we can combine various mutations in an attempt to. Data on gene frequencies of allelic variants were tabulated by roychoudhury and nei 1988 in a japanese man with factor xiii deficiency and a lifelong bleeding tendency, kamura et al. Factor xiii deficiency is an autosomal recessive hematologic disorder characterized by increased bleeding and poor wound healing. National nuclear data center, brookhaven national laboratory, upton, ny 11973, usa. Bleeding disorders as a result of mutations in the fxiii b subunit gene occurs infrequently factor xiii deficiency cases. Factor xiii deficiency the medical biochemistry page. Although the inhibitor against fxiii has recently been focused as the cause of haemorrhagic acquired fxiii deficiency, the pathophysiology of inhibitornegative cases could also be involved.
Factor vii deficiency is a blood clotting disorder that causes prolonged bleeding after an injury or surgery. Our next step is to combine the individual fundamental signals, as in 4. Both of these merge into a third pathway, referred to as the common pathway see. Acquired factor xiii fxiii deficiency is a rare bleeding disorder that can manifest with spontaneous or delayed lifethreatening hemorrhage. Role of carbohydrate in multimeric structure of factor viiivon. Most experts suggest a level of approximately 30 to 45 percent. Factor xiii deficiency, a primer for anesthesiologist medigraphic.
For more information, see pediatric factor xiii deficiency. The incidence of factor xiii deficiency is estimated at one in five million births. Most cases of congenital factor xiii deficiency result from mutation in the a subunit kangsadalampai et al. Hyperfibrinolysis and acquired factor xiii deficiency in.
In severe factor xiii deficiency, life threatening bleeding can occur, particularly intracranial bleeding. Most patients with factor xiii deficiency only lack functional subunit a protein with a frequency of around 1 in 5 million individuals. Factor xiii or fibrin stabilizing factor is a zymogen found from the blood of humans and some other animals. Factor xiii deficiency is a relatively rare hereditary bleeding disorder, which is usually found during infancy or early childhood. Acquired factor xiii deficiency is a general term for individuals who develop factor xiii deficiency that is not inherited, but acquired at some point during life. Included are preparations derived from human plasma antihemophilic factor, cryoprecipitated antihemophilic factor or porcine plasma antihemophilic factor. Mojtaba vahid golpayegani and mahvareh akhgar araghi. Inbal a, oldenburg j, carcao m, rosholm a, tehranchi r, nugent d.
Factor xiii deficiency is an extremely rare bleeding disorder caused by the depletion of factor xiii in blood. Factor vii deficiency is a rare bleeding disorder that varies in severity among affected individuals. Combined heterozygous factor xiiideficiency in a family case report. Factor x deficiency is often caused by an inherited defect in the factor x gene. Fxi deficiency, also known as haemophilia c, is an autosomal bleeding disorder. Factor xiii deficiency haemophilia foundation australia. Intracellular factor xiii including platelet factor xiii comprises only the fxiiia subunits and exists as a homodimer of the a subunit fxiiia 2. Inhibitors were reported in 3 of 72 patients with factor xiii deficiency 4 percent, although only one was. Factor xiii is an inherited bleeding disorder that is caused by complications with factor xiii when the clotting reaction is blocked too soon causing the blood clot to not form. Minor bleeding, as from cuts and abrasions, may respond to conservative measures, such as pressure, ice, and use of antifibrinolytic drugs. This form of the disorder is referred to as type ii factor xiii deficiency.
Factor xii deficiency is most often found when clotting tests are done for routine screening. Researchers have identified an inherited form and a less severe form that is acquired during a persons lifetime. A 48yearold man was referred because of right hip pain due to a hematoma. Factor vii deficiency commonly causes nosebleeds epistaxis, bleeding of the. The deficiency of the clotting factor is either the body does not make enough factor xiii or factor xiii is not working like it should according to, factorxiii protein stabilizes the formation of a. Deficiency of fxiii is associated with reduced clot stability, and therefore ecchymoses or hematomas are usually seen 24 to 36 hours after trauma. Empirical studies on financial markets repub, erasmus university. Factor xiii fxiii deficiency is a rare congenital bleeding disorder estimated to affect 1 in 2 million live births. The majority of these conditions were only identified within the. Even though the initial clot forms and bleeding stops, the. It is inherited in an autosomal recessive fashion, which means factor xiii deficiency affects men and women equally. University of groningen systemic causes of heavy menstrual. Factor x deficiency can also be due to another condition or use of certain medicines.
Factor xiii deficiency is a congenital disorder that is inherited as an autosomal recessive trait and is associated with a variable bleeding tendency acquired factor xiii deficiency is associated with liver failure, inflammatory bowel disease, leukemia, disseminated intravascular coagulation, henochschonlein purpura, systemic lupus. The 12 clotting factors are numbered i through xiii according to the order of their. Factor xiii deficiency is an autosomal recessive disorder. A congenital deficiency of factor ii or a decreased production in the body of factor ii, due to a variety of reasons, can lead to factor ii deficiency disorder signs and symptoms of this condition include bleeding at birth from the umbilical cord, excess bleeding after delivery of child, heavy or excess menstrual bleeding, bleeding after a. The incidence is one in a million to one in five million people, with higher incidence in areas with consanguineous marriage such as iran that has the highest global incidence of the disorder. Endocrine deficiencies are extremely common in children who have been treated. Factor xiii deficiency nord national organization for rare. Factor xii deficiency is a deficiency in the production of factor xii fxii, a plasma glycoprotein and clotting factor that participates in the coagulation cascade and activates factor xi. Tissuespecific hemostasis in mice arteriosclerosis, thrombosis. Factor xiii has a number of other functions in addition to the stabilisation of the fibrin clot and these include the maintenance of pregnancy, bonecartilage growth and wound healing. Diagnosis and management of severe congenital factor xiii. Factor ii deficiency is a very rare blood clotting disorder.
460 1503 869 325 466 156 326 1328 386 1038 1500 814 609 710 1485 635 912 501 918 566 1445 641 1266 536 1376 1526 78 802 957 319 777 897 1352 801 1306 946 74 184 24 282 345 993 812 1184 1466 408