title: Routine preoperative coagulation screening detects a rare bleeding disorder.
abstract: Factor X deficiency is a rare hereditary coagulation disorder. We report a case of congenital factor X deficiency diagnosed preoperatively in an 8-yr-old female child scheduled to undergo corrective surgery for congenital thoracolumbar kyphoscoliosis. Her preoperative coagulation profile revealed prolonged prothrombin time and activated partial thromboplastin time values. Further evaluation showed functional activity of factor X was <8% of the normal activity and was corrected to 10%-40% of the normal activity with fresh frozen plasma. IV tranexamic acid was also administered to reduce intraoperative blood loss. There were no postoperative bleeding complications. This case emphasizes the need for routine preoperative coagulation screening, at least for major surgical procedures.
authors.affiliation: Department of Anesthesiology and Critical Care, Nizam's Institute of Medical Sciences, Hyderabad, Andhra Pradesh, India. nirmala712@sify.co
authors.forename: Nirmala
authors.initials: N
authors.lastname: Jonnavithula
authors.forename: Padmaja
authors.initials: P
authors.lastname: Durga
authors.forename: Ravindra
authors.initials: R
authors.lastname: Pochiraju
authors.forename: Kiran Kumar
authors.initials: KK
authors.lastname: Anne
authors.forename: Gopinath
authors.initials: G
authors.lastname: Ramachandran
mesh_terms: D000933:Antifibrinolytic Agents / Q000008:administration & dosage; D016913:Blood Component Transfusion; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D002648:Child; D005171:Factor X Deficiency / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007738:Kyphosis / Q000150:complications / Q000601:surgery*; D019637:Orthopedic Procedures / Q000009:adverse effects*; D010314:Partial Thromboplastin Time; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D011300:Preoperative Care; D011517:Prothrombin Time; D012600:Scoliosis / Q000150:complications / Q000601:surgery*; D014148:Tranexamic Acid / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid