Acquired Factor XIII Deficiency in a Patient with Metastatic Lung Cancer

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, Portugal

^*Correspondance to: Ana Sofia Mendes 

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Abstract:

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.

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Cite the Article:

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..