• Internal medicine · Jan 2023

    Case Reports

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

    • Akio Onishi, Yuji Shimura, Takahisa Nakamura, Masayoshi Souri, Tsukasa Osaki, Shinsuke Mizutani, Taku Tsukamoto, Tsutomu Kobayashi, Akitada Ichinose, and Junya Kuroda.
    • Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Japan.
    • Intern. Med. 2023 Jan 1; 62 (16): 240124062401-2406.

    AbstractCoagulation 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.

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