Successful treatment of an acquired haemorrhagic diathesis due to factor X deficiency with chemotherapy

Abstract

A 70-yr-old woman presented with a severe haemorrhagic diathesis due to an acquired factor X deficiency. A plasma infusion study showed that exogenous factor X was eliminated very effectively from the patient's circulation. A bone marrow biopsy was consistent with plasma cell dyscrasia. Neither an abdominal fat biopsy nor the bone marrow biopsy confirmed an amyloidosis, although clinically no other diagnosis seemed possible. Treatment with intermittent chemotherapy, consisting of vincristine, cytoxan and prednisone, yielded definite clinical and laboratory improvement.

Autoimmune Coagulation Factor X Deficiency as a Rare Acquired Hemorrhagic Disorder: A Literature Review

“…The authors of two of the seven case reports hypothesized that the causes of acF10D in their patients were related to AL-Amyl, although amyloid deposits were not identified on biopsy. 22 23 What surprised us most was that one of the seven separated cases turned out to be the same patient as a chronic lymphocytic leukemia case published 10 years after original reports, 24 25 who afterward demonstrated the direct deposition of F10 onto amyloid in autopsy specimens. 26 This is in good agreement with the fact that asymptomatic AL-Amyl is present at the time of diagnostic bone marrow biopsy in newly diagnosed patients with MM and smoldering myeloma.…”