title: Symptomatic factor XIII deficiency with normal urea solubility test.
abstract: BACKGROUND
  Factor XIII deficiency is a rarely encountered bleeding disorder traditionally identified by clot dissolution in 5 molar urea (urea solubility test).
  
  
  METHODS
  We report a patient with delayed post-surgical bleeding characteristic of factor XIII deficiency with a normal urea solubility test.
  
  
  RESULTS
  Factor XIII deficiency was identified by an automated assay that measured factor XIII antigen. The patient was successfully treated with cryoprecipitate.
  
  
  CONCLUSIONS
  Patients with excessive bleeding with normal screening tests should be tested for factor XIII using a sensitive assay procedure. The urea solubility assay for factor XIII should be discontinued due to its lack of sensitivity.
authors: Michael J
authors: MJ
authors: Sanfelippo
authors: Joseph J
authors: JJ
authors: Mazza
authors: Richard J
authors: RJ
authors: Mercier
mesh_terms: D000369:Aged, 80 and over; D001777:Blood Coagulation; D001780:Blood Coagulation Tests / Q000379:methods*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D005177:Factor XIII Deficiency / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008297:Male; D019106:Postoperative Hemorrhage / Q000209:etiology* / Q000628:therapy; D011237:Predictive Value of Tests; D012995:Solubility; D016896:Treatment Outcome; D014508:Urea
chemical_list: D014508:Urea