Ana Sofia Mendes*, Marco Dias, Sara Morais, Raquel Romão, Bernardo Teixeira, Cláudia Pedrosa, Isa Peixoto, Paula Fidalgo and António Araújo
Department of Medical Oncology, Porto University Hospital Center, PortugalFulltext PDF
Introduction: Acquired Factor XIII (FXIII) deficiency can result in life-long bleeding tendency and can be caused by enhanced consumption, impaired synthesis, or as an immune-mediated process. The latter can be related with solid neoplasms, through neutralizing or non-neutralizing antibodies. The relationship between FXIII activity and Non-Small Cell Lung Cancer (NSCLC) is not well established. This case report is about a patient with NSCLC and acquired FXIII deficiency.
Materials and Methods: Clinical records were obtained through the electronic process analysis, and the confidentiality of the patient was always assured.
Results and Discussion: A 70-year-old male with no relevant past medical history and a recently diagnosed metastatic NSCLC was admitted for priapism. Five days later, a he developed a bleeding disorder, with slightly elevated coagulation times and normal fibrinogen levels and platelets count. FXIII level was found to be decreased (0.24 IU/mL) and FXIII plasma mixing studies did not
confirm the presence of a neutralizing inhibitor. The FXIII level correction with standard plasma mixing studies was in favor of a non-neutralizing antibody. Despite treatment, hemorrhage control was not achieved and the patient died.
Conclusion: This clinical report describes a rare case of a patient with metastatic NSCLC presenting a severe hemorrhagic event caused by FXIII deficiency immune-mediated by non-neutralizing antibodies and subsequent increased clearance.
Mendes AS, Dias M, Morais S, Romão R, Teixeira B, Pedrosa C, et al. Acquired Factor XIII Deficiency in a Patient with Metastatic Lung Cancer. Clin Oncol. 2021;6:1837..