A Rare Case of Congenital Factor XIII Deficiency Secondary to Hyperconsumption: A Case Report

Acquired Factor XIII (FXIII) deficiency is a rare condition often associated with underlying medical conditions or medications. We present a case of a 23-year-old male, who presented with prolonged bleeding from a traumatic ulcer site on his left leg. Initial laboratory investigations revealed a severe deficiency in FXIII activity (30%) and antigen levels (25%), with no evidence of congenital disorders or other underlying pathologies. Further evaluation indicated a pattern of hyperconsumption due to ongoing bleeding episodes in the form of excessive use of clotting factors due to repeated bleeding episodes and impaired clot stability, leading to a coagulopathy where factors are consumed faster than they can be produced. The patient was treated with six units of cryoprecipitate to address the bleeding and was started on high-end antibiotics, including meropenem and vancomycin, to manage a suspected septic process. This comprehensive approach led to significant clinical improvement, with the resolution of symptoms and stabilization of the ulcer site. This case highlights the importance of considering acquired FXIII deficiency in patients with unexplained bleeding diathesis, especially in the context of alcohol abuse or conditions associated with hyperconsumption. Early recognition and immediate treatment are crucial for improving prognostic outcomes for these patients.