A CASE OF APPENDECTOMY OF CONGENITAL FACTOR XI DEFICIENCY

This paper presents a case of congenital factor XI deficiency which was clarified by prominent prolongation of APTT in preoperative examination for acute appendicitis, as well as a study of the patient's family. A 48-year-old man after diagnosed as having appendicitis was referred to the hospit...

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Published inNihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 60; no. 10; pp. 2775 - 2777
Main Author SASAKI, Hideaki
Format Journal Article
LanguageEnglish
Published Japan Surgical Association 1999
Online AccessGet full text
ISSN1345-2843
1882-5133
1882-5133
DOI10.3919/jjsa.60.2775

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Abstract This paper presents a case of congenital factor XI deficiency which was clarified by prominent prolongation of APTT in preoperative examination for acute appendicitis, as well as a study of the patient's family. A 48-year-old man after diagnosed as having appendicitis was referred to the hospital by a small island clinic. Preoperative evaluation showed marked prolongation of APTT (127.0 second with a standard of 29.6 sec.). When using a 1:1 mixture of the patient and normal plasma, the prolongation of APTT was normalized. An appendectomy was successfully performed. Any transfusion of fresh frozen plasma was not required. The patient revealed no bleeding tendency during hospitalization, but postoperative evaluation indicated that his factor XI was less than 3%. Several months later, his son, who also underwent an appendectomy for appendicitis, was found to have a prolonged APTT of 38.3 sec. (31.0 sec.), and a factor XI of 36%. His daughter, who had undergone a cervical spine surgery for Morquio's disease, had a prolonged APTT of 35.8 sec. (30.4 sec.) and a factor XI of 35%. His wife had normal coagulation tests. These facts suggest that the patient has homozygous and his children heterozygous factor XI deficiency.
AbstractList This paper presents a case of congenital factor XI deficiency which was clarified by prominent prolongation of APTT in preoperative examination for acute appendicitis, as well as a study of the patient's family. A 48-year-old man after diagnosed as having appendicitis was referred to the hospital by a small island clinic. Preoperative evaluation showed marked prolongation of APTT (127.0 second with a standard of 29.6 sec.). When using a 1:1 mixture of the patient and normal plasma, the prolongation of APTT was normalized. An appendectomy was successfully performed. Any transfusion of fresh frozen plasma was not required. The patient revealed no bleeding tendency during hospitalization, but postoperative evaluation indicated that his factor XI was less than 3%. Several months later, his son, who also underwent an appendectomy for appendicitis, was found to have a prolonged APTT of 38.3 sec. (31.0 sec.), and a factor XI of 36%. His daughter, who had undergone a cervical spine surgery for Morquio's disease, had a prolonged APTT of 35.8 sec. (30.4 sec.) and a factor XI of 35%. His wife had normal coagulation tests. These facts suggest that the patient has homozygous and his children heterozygous factor XI deficiency.
Author SASAKI, Hideaki
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References 2) Harold RR: chap. 135 Hemophilia and related conditions. Ed. by Ernest B, et al. Williams Hematology. Fifth Edition, McGraw-Hill Inc., New York, 1995, p 1433-1434
5) 斎藤英彦: III. 血液凝固・線溶系検査,第XI因子.日本臨牀,53,日本臨牀社,大阪, 1995, p84-86
8) Sidney H, Constantin G, Jean-Marie H, et al: A prospective multicenter evaluation of preoperative hemostatic screening tests. Am J Surg 170: 19-23. 1995
1) Rosenthal RL, Dreski OH, Rosenthal N: New hemophilia like disease caused by deficiency of a third plasma thromboplastin factor. Pros Soc Exp Biol Med 82: 171-174, 1953
6) Giancarlo C. Marco R, Francesco R: Clinical usefulness of desmopressin for prevention of surgical bleeding in patients with symptomatic heterozygous factor XI deficiency. Br J Haema 94: 168-170, 1996
3) 朝海 怜:血液凝固第XI因子欠損症の分子病理.医のあゆみ 160: 542-545. 1992
4) 佐藤公淑;先天性第XI因子欠乏症の麻酔経験.臨 麻 21: 1071-1073. 1997
7) Bolton-Maggs PHB, Colvin BT, Satchi B, et al: Thrombogenic potential of factor XI concentrate. Lancet 344: 748-749, 1994
References_xml – reference: 1) Rosenthal RL, Dreski OH, Rosenthal N: New hemophilia like disease caused by deficiency of a third plasma thromboplastin factor. Pros Soc Exp Biol Med 82: 171-174, 1953
– reference: 3) 朝海 怜:血液凝固第XI因子欠損症の分子病理.医のあゆみ 160: 542-545. 1992
– reference: 5) 斎藤英彦: III. 血液凝固・線溶系検査,第XI因子.日本臨牀,53,日本臨牀社,大阪, 1995, p84-86
– reference: 6) Giancarlo C. Marco R, Francesco R: Clinical usefulness of desmopressin for prevention of surgical bleeding in patients with symptomatic heterozygous factor XI deficiency. Br J Haema 94: 168-170, 1996
– reference: 4) 佐藤公淑;先天性第XI因子欠乏症の麻酔経験.臨 麻 21: 1071-1073. 1997
– reference: 7) Bolton-Maggs PHB, Colvin BT, Satchi B, et al: Thrombogenic potential of factor XI concentrate. Lancet 344: 748-749, 1994
– reference: 8) Sidney H, Constantin G, Jean-Marie H, et al: A prospective multicenter evaluation of preoperative hemostatic screening tests. Am J Surg 170: 19-23. 1995
– reference: 2) Harold RR: chap. 135 Hemophilia and related conditions. Ed. by Ernest B, et al. Williams Hematology. Fifth Edition, McGraw-Hill Inc., New York, 1995, p 1433-1434
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Title A CASE OF APPENDECTOMY OF CONGENITAL FACTOR XI DEFICIENCY
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