Recurrent Hematomas following a Revision Total Hip Arthroplasty in Acquired Coagulation Factor XIII Deficiency

Coagulation factor XIII (FXIII) is the final enzyme in the coagulation cascade and plays an important role in catalyzing the intermolecular cross-linking of fibrin polymers. FXIII deficiency is a rare disorder that presents with recurrent soft tissue bleeding. In this case report, we describe a pati...

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Main Authors: Yoshinori Takashima, Shingo Hashimoto, Tomoyuki Kamenaga, Masanori Tsubosaka, Yuichi Kuroda, Kazuhiro Takeuchi, Koji Takayama, Shinya Hayashi, Ryosuke Kuroda, Tomoyuki Matsumoto
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Case Reports in Orthopedics
Online Access:http://dx.doi.org/10.1155/2019/4038963
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author Yoshinori Takashima
Shingo Hashimoto
Tomoyuki Kamenaga
Masanori Tsubosaka
Yuichi Kuroda
Kazuhiro Takeuchi
Koji Takayama
Shinya Hayashi
Ryosuke Kuroda
Tomoyuki Matsumoto
author_facet Yoshinori Takashima
Shingo Hashimoto
Tomoyuki Kamenaga
Masanori Tsubosaka
Yuichi Kuroda
Kazuhiro Takeuchi
Koji Takayama
Shinya Hayashi
Ryosuke Kuroda
Tomoyuki Matsumoto
author_sort Yoshinori Takashima
collection DOAJ
description Coagulation factor XIII (FXIII) is the final enzyme in the coagulation cascade and plays an important role in catalyzing the intermolecular cross-linking of fibrin polymers. FXIII deficiency is a rare disorder that presents with recurrent soft tissue bleeding. In this case report, we describe a patient with recurrent hematomas, following a revision total hip arthroplasty (THA). A 50-year-old female patient with no past history of bleeding and with a normal perioperative coagulation profile presented with recurrent hip joint hematomas. Her plasma FXIII activity showed a slight decrease (69%). Therefore, the patient was diagnosed with an acquired deficiency and was administered FXIII to correct it. The bleeding did not recur once the FXIII activity had returned to a normal level (76%). At 2 months after the second evacuation procedure, the patient was discharged from the hospital in an ambulatory state. There has been no recurrence of a hematoma since. We managed a rare case of acquired FXIII deficiency, which highlighted that a patient can present with an acquired bleeding disorder despite having a normal coagulation profile. An acquired FXIII deficiency should be suspected in patients with inexplicable, sudden-onset bleeding, as early diagnosis and treatment are important to prevent life-threatening complications.
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spelling doaj-art-975438c077df462d992822a8a777f59e2025-02-03T06:12:23ZengWileyCase Reports in Orthopedics2090-67492090-67572019-01-01201910.1155/2019/40389634038963Recurrent Hematomas following a Revision Total Hip Arthroplasty in Acquired Coagulation Factor XIII DeficiencyYoshinori Takashima0Shingo Hashimoto1Tomoyuki Kamenaga2Masanori Tsubosaka3Yuichi Kuroda4Kazuhiro Takeuchi5Koji Takayama6Shinya Hayashi7Ryosuke Kuroda8Tomoyuki Matsumoto9Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe 650-0017, JapanDepartment of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe 650-0017, JapanDepartment of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe 650-0017, JapanDepartment of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe 650-0017, JapanDepartment of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe 650-0017, JapanDepartment of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe 650-0017, JapanDepartment of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe 650-0017, JapanDepartment of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe 650-0017, JapanDepartment of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe 650-0017, JapanDepartment of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe 650-0017, JapanCoagulation factor XIII (FXIII) is the final enzyme in the coagulation cascade and plays an important role in catalyzing the intermolecular cross-linking of fibrin polymers. FXIII deficiency is a rare disorder that presents with recurrent soft tissue bleeding. In this case report, we describe a patient with recurrent hematomas, following a revision total hip arthroplasty (THA). A 50-year-old female patient with no past history of bleeding and with a normal perioperative coagulation profile presented with recurrent hip joint hematomas. Her plasma FXIII activity showed a slight decrease (69%). Therefore, the patient was diagnosed with an acquired deficiency and was administered FXIII to correct it. The bleeding did not recur once the FXIII activity had returned to a normal level (76%). At 2 months after the second evacuation procedure, the patient was discharged from the hospital in an ambulatory state. There has been no recurrence of a hematoma since. We managed a rare case of acquired FXIII deficiency, which highlighted that a patient can present with an acquired bleeding disorder despite having a normal coagulation profile. An acquired FXIII deficiency should be suspected in patients with inexplicable, sudden-onset bleeding, as early diagnosis and treatment are important to prevent life-threatening complications.http://dx.doi.org/10.1155/2019/4038963
spellingShingle Yoshinori Takashima
Shingo Hashimoto
Tomoyuki Kamenaga
Masanori Tsubosaka
Yuichi Kuroda
Kazuhiro Takeuchi
Koji Takayama
Shinya Hayashi
Ryosuke Kuroda
Tomoyuki Matsumoto
Recurrent Hematomas following a Revision Total Hip Arthroplasty in Acquired Coagulation Factor XIII Deficiency
Case Reports in Orthopedics
title Recurrent Hematomas following a Revision Total Hip Arthroplasty in Acquired Coagulation Factor XIII Deficiency
title_full Recurrent Hematomas following a Revision Total Hip Arthroplasty in Acquired Coagulation Factor XIII Deficiency
title_fullStr Recurrent Hematomas following a Revision Total Hip Arthroplasty in Acquired Coagulation Factor XIII Deficiency
title_full_unstemmed Recurrent Hematomas following a Revision Total Hip Arthroplasty in Acquired Coagulation Factor XIII Deficiency
title_short Recurrent Hematomas following a Revision Total Hip Arthroplasty in Acquired Coagulation Factor XIII Deficiency
title_sort recurrent hematomas following a revision total hip arthroplasty in acquired coagulation factor xiii deficiency
url http://dx.doi.org/10.1155/2019/4038963
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