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Recurrent Bleeding after Head Trauma Caused by Acquired Factor XIII Deficiency
Nao Wakabayashi1, Hiroshi Nishioka2, Shunsuke Yuzuriha2
1Department of Plastic and Reconstructive Surgery, Japanese Red Cross Society Nagano Hospital, Nagano, Japan.
Plastic and Reconstructive Surgery. Global Open
|February 21, 2022
Summary
Acquired Factor XIII (FXIII) deficiency can cause prolonged bleeding and delayed healing. Early detection and treatment with FXIII concentrate are crucial for recovery, especially after trauma.
Area of Science:
- Hematology
- Coagulation Disorders
- Surgical Complications
Background:
- Factor XIII (FXIII) is essential for stabilizing blood clots through fibrin cross-linking.
- FXIII deficiency can lead to persistent bleeding, impaired wound healing, and tissue repair issues.
Observation:
- A 66-year-old man with a history of leukemia and aortic dissection presented with recurrent bleeding and hematoma after head trauma.
- Routine coagulation tests were normal, prompting further investigation for a coagulation disorder.
Findings:
- Acquired FXIII deficiency was diagnosed 39 days post-injury based on low FXIII activity.
- Treatment with concentrated human coagulation FXIII (Fibrogammin P) led to complete healing of the head contusion by day 55.
Implications:
- Acquired FXIII deficiency should be suspected in cases of unexplained recurrent bleeding or delayed healing, even with normal routine coagulation tests.
- Plastic surgeons must be aware of FXIII deficiency as a potential cause of life-threatening complications after injury.
- Prompt diagnosis and FXIII concentrate administration are vital for managing this condition and ensuring successful patient recovery.
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