A case of acquired factor X deficiency with in vivo and in vitro evidence of inhibitor activity directed against factor X.
A 67-year-old woman had symptoms of an upper respiratory tract infection for which she received a five-day course of erythromycin. Epistaxis and gross hematuria subsequently developed, and the patient was found to have a selective Factor X deficiency. She received supportive therapy and prothrombin complex concentrates (Factors II, VII, IX, and X), with subsequent resolution of her transient Factor X deficiency. Her hospital course, however, was complicated by the development of multiple cerebral infarctions. This is the tenth reported case of transient Factor X deficiency not associated with amyloidosis. In seven of the previous cases, as in this patient, the deficiency was associated with a preceding upper respiratory infection. This is the only case, however, with evidence of inhibitory activity in the plasma that was directed toward Factor X.
Mulhare
P E
PE
Department of Pathology, University of Vermont, College of Medicine, Burlington 05405.
Tracy
P B
PB
Golden
E A
EA
Branda
R F
RF
Bovill
E G
EG
D000368:Aged; D001760:Bleeding Time; D001779:Blood Coagulation Factors / Q000627:therapeutic use; D004917:Erythromycin / Q000627:therapeutic use; D005170:Factor X / Q000032:analysis / Q000037:antagonists & inhibitors*; D005171:Factor X Deficiency / Q000097:blood / Q000628:therapy; D005260:Female; D006801:Humans; D012141:Respiratory Tract Infections / Q000188:drug therapy
D001779:Blood Coagulation Factors; C025667:prothrombin complex concentrates; D004917:Erythromycin; D005170:Factor X