Management of Acquired Factor X Deficiency Caused by In Vitro Non-neutralizing Anti-factor X Autoantibodies with Pre-emptive Corticosteroid Therapy

Intern Med. 2023;62(16):2401-2406. doi: 10.2169/internalmedicine.0849-22. Epub 2023 Aug 15.

Abstract

Coagulation factor X (FX) deficiency causes severe hemorrhagic symptoms. We herein report a 90-year-old man with hemorrhagic symptoms and prolongation of prothrombin time (PT) and activated partial thromboplastin time (APTT). Cross-mixing tests showed a factor deficiency pattern, but administration of plasma products was not effective. Acquired coagulation factor deficiency was suspected, and immunosuppressive therapy was started. After the intervention, his hemorrhagic symptoms improved. A decrease in FX activity was later confirmed, and anti-FX autoantibody was retrospectively detected by an enzyme-linked immunosorbent assay. Immediate intervention is important for patients suspected of having acquired coagulation factor deficiency.

Keywords: acquired hemophilia; corticosteroid; factor X deficiency.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones
  • Aged, 80 and over
  • Autoantibodies
  • Blood Coagulation Factors
  • Factor X Deficiency* / drug therapy
  • Humans
  • Male
  • Retrospective Studies

Substances

  • Adrenal Cortex Hormones
  • Autoantibodies
  • Blood Coagulation Factors