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Thrombotic Events in Asymptomatic FXII Deficiency versus Symptomatic FXI Deficiency: Surprising Observations.

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Factor XII (FXII) deficiency offers no protection against arterial or venous thrombosis. In contrast, Factor XI (FXI) deficiency, a symptomatic bleeding disorder, appears to protect against venous thrombosis.

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Area of Science:

  • Hematology
  • Thrombosis Research
  • Congenital Bleeding Disorders

Background:

  • Congenital clotting defects can influence thrombotic risk.
  • Factor XII (FXII) deficiency is asymptomatic, while Factor XI (FXI) deficiency is symptomatic (bleeding).

Purpose of the Study:

  • To compare the thrombotic protection offered by asymptomatic FXII deficiency versus symptomatic FXI deficiency.

Main Methods:

  • Systematic PubMed search and review of personal records for patients with FXII or FXI deficiency and thrombosis.
  • Inclusion criteria: hereditary pattern, specific clotting assay, factor activity <30%.

Main Results:

  • FXII deficiency: 28 patients with arterial thrombosis (mainly myocardial infarction), 29 with venous thrombosis (arterial/venous ratio 0.96).
  • FXI deficiency: 43 patients with arterial thrombosis, 10 with venous thrombosis (arterial/venous ratio 4.3).

Conclusions:

  • FXII deficiency does not protect against arterial or venous thrombosis.
  • FXI deficiency does not protect against arterial thrombosis but appears to protect against venous thrombosis.
  • Symptomatic FXI deficiency provides venous thrombosis protection, unlike asymptomatic FXII deficiency.