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Anesth Analg 2009; 108:76-78
© 2009 International Anesthesia Research Society
doi: 10.1213/ane.0b013e3181875e51
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CARDIOVASCULAR ANESTHESIOLOGY

Routine Preoperative Coagulation Screening Detects a Rare Bleeding Disorder

Nirmala Jonnavithula, MD, Padmaja Durga, MD, DNB, Ravindra Pochiraju, MD, Kiran Kumar Anne, MD, DNB, and Gopinath Ramachandran, MD, FFARCS I

From the Department of Anesthesiology and Critical Care, Nizam’s Institute of Medical Sciences, Hyderabad, Andhra Pradesh, India.

Address correspondence and reprint requests to Dr. Nirmala Jonnavithula, 202,10-2-289/12; Sripada Residency, Shantinagar 1st lane, Near Masab Tank, Hyderabad-500028. Address e-mail to nirmala712{at}sify.com.

Abstract

Factor X deficiency is a rare hereditary coagulation disorder. We report a case of congenital factor X deficiency diagnosed preoperatively in an 8-yr-old female child scheduled to undergo corrective surgery for congenital thoracolumbar kyphoscoliosis. Her preoperative coagulation profile revealed prolonged prothrombin time and activated partial thromboplastin time values. Further evaluation showed functional activity of factor X was <8% of the normal activity and was corrected to 10%-40% of the normal activity with fresh frozen plasma. IV tranexamic acid was also administered to reduce intraoperative blood loss. There were no postoperative bleeding complications. This case emphasizes the need for routine preoperative coagulation screening, at least for major surgical procedures.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins and Stanford University Libraries' HighWire Press®. Copyright 2009 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2009 by the International Anesthesia Research Society.