title: Ischemic stroke in a patient with moderate to severe inherited factor VII deficiency.
abstract: Thrombosis is known to occur in patients with rare inherited bleeding disorders, usually in the presence of a thrombotic risk factor such as surgery and/or factor replacement therapy, but sometimes spontaneously. We present the case of a 72-year-old African American male diagnosed with congenital factor VII (FVII) deficiency after presenting with ischemic stroke, presumably embolic, in the setting of atherosclerotic carotid artery stenosis. The patient had an international normalized ratio (INR) of 2.0 at presentation, with FVII activity of 6% and normal Extem clotting time in rotational thromboelastometry. He was treated with aspirin (325 mg daily) and clopidogrel (75 mg daily) with no additional bleeding or thrombotic complications throughout his admission. This case provides further evidence that moderate to severe FVII deficiency does not protect against thrombosis.
authors: Department of Pathology, Division of Transfusion Medicine and Hemostasis, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors: Manasa
authors: M
authors: Reddy
authors: Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors: Bernard
authors: B
authors: Tawfik
authors: Department of Pathology, Division of Transfusion Medicine and Hemostasis, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors: Chakri
authors: C
authors: Gavva
authors: Department of Pathology, Division of Transfusion Medicine and Hemostasis, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors: Sean
authors: S
authors: Yates
authors: Department of Pathology, Division of Transfusion Medicine and Hemostasis, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors: Nicole
authors: N
authors: De Simone
authors: Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors: Sandra L
authors: SL
authors: Hofmann
authors: Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors: Siayareh
authors: S
authors: Rambally
authors: Department of Pathology, Division of Transfusion Medicine and Hemostasis, University of Texas Southwestern Medical Center, Dallas, Texas, USA. Electronic address: Ravi.Sarode@UTSouthwestern.edu.
authors: Ravi
authors: R
authors: Sarode
mesh_terms: D000368:Aged; D001780:Blood Coagulation Tests; D002545:Brain Ischemia / Q000150:complications / Q000188:drug therapy*; D005168:Factor VII Deficiency / Q000150:complications* / Q000188:drug therapy / Q000235:genetics*; D006801:Humans; D040582:Inheritance Patterns / Q000235:genetics*; D008297:Male; D020521:Stroke / Q000150:complications* / Q000188:drug therapy
keywords: Factor VII deficiency; Stroke; Thrombosis