Effective hemostasis during minor surgery in a case of hereditary combined deficiency of vitamin K-dependent clotting factors

Clin Appl Thromb Hemost. 2010 Apr;16(2):221-3. doi: 10.1177/1076029608330473. Epub 2009 Jan 13.

Abstract

Combined deficiency of the vitamin K-dependent clotting factors (VKCFD) is a rare bleeding disorder involving defective gamma-carboxylation of coagulation factors II , VII, IX and X as well as natural anticoagulants protein C and protein S. The disease is characterized by a cluster of different, often life threatening, bleeding symptoms occurring both spontaneously and in a surgical setting. In the present paper we describe two different treatment modalities to be used both in a programmed surgical procedure and in an emergency scenario. As this disease is a natural model that resembles oral anticoagulation, our experience discloses a possible rationale in the use of recombinant activated FVII for warfarin reversal.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biopsy
  • Blood Coagulation Disorders, Inherited / complications*
  • Blood Coagulation Disorders, Inherited / drug therapy
  • Blood Coagulation Disorders, Inherited / genetics
  • Blood Coagulation Tests
  • Blood Loss, Surgical*
  • Factor VII / genetics
  • Factor VII Deficiency / drug therapy
  • Factor VII Deficiency / genetics*
  • Factor VIIa / therapeutic use
  • Female
  • Gastroscopy
  • Hemostasis, Surgical / methods*
  • Homozygote
  • Humans
  • Mixed Function Oxygenases / deficiency*
  • Mixed Function Oxygenases / genetics
  • Recombinant Proteins / therapeutic use
  • Tooth Extraction*
  • Vitamin K / therapeutic use
  • Vitamin K Epoxide Reductases

Substances

  • Recombinant Proteins
  • Vitamin K
  • Factor VII
  • recombinant FVIIa
  • Mixed Function Oxygenases
  • Vitamin K Epoxide Reductases
  • Factor VIIa