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Circulating anticoagulant against factor XII in smoldering leukemia
Acta Haematologica
|January 1, 1982
Summary
A rare circulating anticoagulant targeting factor XII was found in a patient with smoldering leukemia. This IgG antibody caused both bleeding and clotting despite low platelets, a unique presentation.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Smoldering leukemia is an asymptomatic precursor to active leukemia.
- Circulating anticoagulants can cause bleeding or clotting disorders.
- Factor XII (FXII) plays a role in the intrinsic coagulation pathway.
Observation:
- A patient with smoldering leukemia presented with both mucosal bleeding and thromboembolic events.
- Severe thrombocytopenia was noted in the patient.
- A circulating anticoagulant targeting factor XII was identified.
Findings:
- The anticoagulant activity was present in both plasma and serum.
- The anticoagulant was heat-stable (56°C for 30 min) and not adsorbed by BaSO4 or Al(OH)3.
- The anticoagulant was determined to be a non-dialyzable IgG antibody.
Implications:
- This case highlights a potential link between smoldering leukemia and the development of factor XII inhibitors.
- The presence of an IgG anticoagulant against FXII can lead to paradoxical bleeding and thrombosis.
- Further research is warranted to understand the pathogenesis and management of this rare complication.