title: Recurrent Post Tonsillectomy Secondary Hemorrhage in Patients with Factor XIII Deficiency: A Case Series and Review of Literature.
abstract: BACKGROUND Post-tonsillectomy hemorrhage (PTH) has been reported in the literature as a serious complication after tonsillectomy that has high morbidity and can be life threatening. In cases of recurrent secondary PTH, one should consider coagulopathies as the hidden pathology. Factor XIII deficiency is very rare, suggested to be present 1 in 2 million people. Patients with undiagnosed factor XIII deficiency with secondary PTH are extremely rare.  CASE REPORT We report on the cases of six patients (four adults and two children) who presented with recurrent attacks of secondary PTH. CONCLUSIONS Recurrent, severe PTH could be related to undiagnosed hematological disorders.
authors.affiliation: Department of Otorhinolaryngology and Head & Neck Surgery (ORL-HNS), Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Hassen
authors.initials: H
authors.lastname: Mohammed
authors.affiliation: Department of Otorhinolaryngology and Head & Neck Surgery (ORL-HNS), Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Zaid Abu Rajab
authors.initials: ZA
authors.lastname: ALtamimi
authors.affiliation: Department of Otorhinolaryngology and Head & Neck Surgery (ORL-HNS), Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Rashid
authors.initials: R
authors.lastname: Sheikh
authors.affiliation: Department of Otorhinolaryngology and Head & Neck Surgery (ORL-HNS), Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Hayam
authors.initials: H
authors.lastname: Al Taweel
authors.affiliation: Department of Otorhinolaryngology and Head & Neck Surgery (ORL-HNS), Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Shanmugam
authors.initials: S
authors.lastname: Ganesan
mesh_terms: D000328:Adult; D002675:Child, Preschool; D005176:Factor XIII / Q000378:metabolism*; D005177:Factor XIII Deficiency / Q000097:blood / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006489:Hemostatic Techniques; D006801:Humans; D008297:Male; D019106:Postoperative Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D012008:Recurrence; D014068:Tonsillectomy / Q000009:adverse effects*; D014069:Tonsillitis / Q000150:complications / Q000601:surgery*; D055815:Young Adult
chemical_list: D005176:Factor XIII