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Refractory Duodenal Bleeding Ulcers Successfully Treated with Factor XIII Transfusion
Yusuke Yamada1, Tomohiro Abe1, Hidenobu Ochiai1
1Department of Trauma and Critical Care Medicine, University of Miyazaki Hospital, Japan.
Internal Medicine (Tokyo, Japan)
|February 15, 2021
Summary
A patient with autoimmune hepatitis experienced severe duodenal bleeding due to low factor XIII (FXIII) activity. FXIII concentrate successfully stopped the bleeding, resolving the acute hepatic and kidney injury.
Area of Science:
- Gastroenterology
- Hematology
- Nephrology
Background:
- Autoimmune hepatitis can present with gastrointestinal complications.
- Acute hepatic dysfunction and kidney injury require comprehensive management.
Observation:
- A 67-year-old woman with autoimmune hepatitis developed multiple duodenal ulcers.
- Persistent gastrointestinal bleeding and anemia despite proton pump inhibitors and blood transfusions.
Findings:
- Endoscopic examination revealed oozing from duodenal mucosa.
- Low factor XIII (FXIII) activity was identified as the underlying cause.
- Administration of FXIII concentrate effectively achieved hemostasis.
Implications:
- Factor XIII deficiency should be considered in patients with refractory gastrointestinal bleeding.
- FXIII concentrate is a viable treatment for bleeding associated with FXIII deficiency.
- Successful treatment led to resolution of bleeding and patient discharge.
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