title: Acquired Factor XI Inhibitor Presenting as Spontaneous Bilateral Subdural Hematoma in an Elderly Patient.
abstract: Development of autoantibodies against coagulation factors is an uncommon bleeding disorder associated with cancer, autoimmune conditions, pregnancy, or no apparent disease. Spontaneous FVIII inhibitors are the most frequently encountered; those against FXI have been only anecdotally reported. We report a case of acquired FXI inhibitor presenting as fatal intracranial spontaneous bleeding in an elderly patient with history of cancer and previous transfusions. Few cases of acquired FXI inhibitor have been reported in association with connective tissue disease, cancer, or surgery. Bleeding includes mucocutaneous bleeding, postsurgical hemorrhage, or life-threatening events. Treatment consists of arresting the bleeding and inhibitor eradication. High degree of suspicion is essential to promptly diagnose and treat this uncommon condition.
authors.affiliation: Department of Internal Medicine, "S. Giovanni di Dio" Hospital, Via di Torregalli, 3-50143 Florence, Italy.
authors.forename: Natale
authors.identifier: 0000-0002-1572-8032
authors.initials: N
authors.lastname: Vazzana
authors.affiliation: Department of Internal Medicine, "S. Giovanni di Dio" Hospital, Via di Torregalli, 3-50143 Florence, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Scarti
authors.affiliation: Department of Internal Medicine, "S. Giovanni di Dio" Hospital, Via di Torregalli, 3-50143 Florence, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Beltrame
authors.affiliation: Department of Clinical Chemistry, "S. Giovanni di Dio" Hospital, Via di Torregalli, 3-50143 Florence, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Picchi
authors.affiliation: Department of Internal Medicine, "S. Giovanni di Dio" Hospital, Via di Torregalli, 3-50143 Florence, Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Taccetti
authors.affiliation: Department of Internal Medicine, "S. Giovanni di Dio" Hospital, Via di Torregalli, 3-50143 Florence, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Fortini