title: Clinical profile of patients with rare inherited coagulation disorders: a retrospective analysis of 67 patients from northern India.
abstract: BACKGROUND
  Inherited bleeding disorders are characterized by the absence or reduced level of clotting factors, and the clinical manifestations vary according to the type and magnitude of the deficient factor.
  
  
  OBJECTIVE
  To study the clinical presentation of the rare inherited coagulation factor disorders in a tertiary care hospital and to compare the data from those reported in other populations.
  
  
  METHODS
  Sixty-seven patients, who presented to the Department of Hematology, All India Institute of Medical Sciences, New Delhi, were evaluated retrospectively from 2005 to 2011. The tests performed included platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombin time (TT), factors assay and clot solubility test in 5 M urea. Factor XI assays were aPTT based while factors V, VII and X assays were PT based.
  
  
  RESULTS
  Male to female ratio was 2:1. The median age of onset of the first episode of bleeding was at 6 months (range, from birth to 20 years) whereas the median age of presentation to our hospital was 9 years (range, 2 months to 54 years). The most common deficient factor was factor X (43%), followed by factor XIII (27%) and factor VII (10%).
  
  
  CONCLUSIONS
  There is a wide gap between the initial manifestation of the bleeding disorders and first presentation to the tertiary care hospital for assessment and treatment. Factor X deficiency is the most common among these rare coagulation disorders in our population, whereas factor VII deficiency is more common in Iranian and North American population.
authors.affiliation: Department of Hematology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sanjeev Kumar
authors.initials: SK
authors.lastname: Sharma
authors.forename: Suman
authors.initials: S
authors.lastname: Kumar
authors.forename: Tulika
authors.initials: T
authors.lastname: Seth
authors.forename: Pravas
authors.initials: P
authors.lastname: Mishra
authors.forename: Narendra
authors.initials: N
authors.lastname: Agrawal
authors.forename: Gurmeet
authors.initials: G
authors.lastname: Singh
authors.forename: Avinash Kumar
authors.initials: AK
authors.lastname: Singh
authors.forename: Manoranjan
authors.initials: M
authors.lastname: Mahapatra
authors.forename: Seema
authors.initials: S
authors.lastname: Tyagi
authors.forename: Haraprasad
authors.initials: H
authors.lastname: Pati
authors.forename: Renu
authors.initials: R
authors.lastname: Saxena