Factor XIII deficiency.
Inherited factor XIII (FXIII) deficiency is a rare bleeding disorder that can present with umbilical bleeding during the neonatal period, delayed soft tissue bruising, mucosal bleeding and life-threatening intracranial haemorrhage. FXIII deficiency has also been associated with poor wound healing and recurrent miscarriages. FXIII plays an integral role in haemostasis by catalysing the cross-linking of fibrin, platelet membrane and matrix proteins throughout thrombus formation, thus stabilizing the blood clot. The molecular basis of FXIII deficiency is characterized by a high degree of heterogeneity, which contributes to the different clinical manifestations of the disease. There have been more than 60 FXIII mutations identified in the current literature. In addition, single nucleotide polymorphisms have been described, some of which have been shown to affect FXIII activity, contributing further to the heterogeneity in patient presentation and severity of clinical symptoms. Although there is a lifelong risk of bleeding, the prognosis is excellent when current prophylactic treatment is available using cryoprecipitate or plasma-derived FXIII concentrate.
Hsieh
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Division of Hematology, Children's Hospital of Orange County, Orange, CA 92868, USA. djn0@choc.org
Nugent
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D000022:Abortion, Spontaneous / Q000097:blood / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D019943:Amino Acid Substitution; D001777:Blood Coagulation / Q000502:physiology; D019774:Blood Coagulation Factor Inhibitors / Q000097:blood; D001780:Blood Coagulation Tests; D004252:DNA Mutational Analysis; D005169:Factor VIII / Q000008:administration & dosage; D005176:Factor XIII / Q000737:chemistry / Q000235:genetics / Q000502:physiology* / Q000627:therapeutic use; D005177:Factor XIII Deficiency / Q000097:blood / Q000175:diagnosis / Q000235:genetics*; D005260:Female; D005340:Fibrinogen / Q000008:administration & dosage; D006470:Hemorrhage / Q000097:blood* / Q000188:drug therapy; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009154:Mutation; D010949:Plasma; D020641:Polymorphism, Single Nucleotide / Q000235:genetics; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood / Q000188:drug therapy; D012720:Severity of Illness Index; D014945:Wound Healing / Q000502:physiology
D019774:Blood Coagulation Factor Inhibitors; C026912:cryoprecipitate coagulum; C064015:factor XIII subunit A; D005169:Factor VIII; D005340:Fibrinogen; D005176:Factor XIII