Anesthesia strategy for factor X deficiency coagulopathy: case report

Area of Science:

• Anesthesiology
• Hematology
• Coagulopathies

Background:

• Factor X deficiency is a rare inherited bleeding disorder with diverse clinical manifestations.
• Anesthesia management for patients with coagulopathies requires careful planning to mitigate bleeding risks.
• Surgical procedures in patients with rare factor deficiencies necessitate specialized protocols.

Observation:

• A 26-year-old female patient, classified as ASA II, with congenital Factor X deficiency was scheduled for ovarian neoplasm excision.
• Pre-anesthetic evaluation revealed prolonged Prothrombin Time (PT) and Activated Partial Thromboplastin Time (aPTT), and an elevated International Normalized Ratio (INR).
• Physical examination and other laboratory tests were within normal limits.

Findings:

• The patient's coagulation profile (PT 22.1s, INR 1.99, aPTT 41.4s) indicated a significant deficiency in Factor X activity.
• The case highlights the importance of thorough bleeding history assessment in patients with known or suspected coagulopathies.
• Standard laboratory coagulation tests are essential for identifying and quantifying factor deficiencies prior to anesthesia.

Implications:

• Development of specific anesthesia protocols for Factor X deficiency patients is critical for surgical safety.
• Pre-operative coagulation screening is vital for all patients, especially those with a history of bleeding or known coagulopathies.
• This case underscores the need for multidisciplinary collaboration between anesthesiologists and hematologists in managing rare bleeding disorders.