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Rugeri L, Martinaud C, Beurrier P, Borg Y, Chambost H, Chirila-Hetsch M, Desprez D, Harroche A, Milien V, Pan-Petesch B, Meunier S. Gynecological and obstetric outcome in the French cohort of women with factor XIII deficiency. Thromb Res 2020; 191:22-25. [PMID: 32360976 DOI: 10.1016/j.thromres.2020.04.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 03/17/2020] [Accepted: 04/08/2020] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Congenital factor XIII deficiency is a very rare bleeding disorder affecting 33 patients in France. Besides its role in fibrin clot stabilization, factor XIII is involved in placental attachment. Fetal miscarriages represent a frequent and concerning issue for these patients. The aim of the present study was to describe clinical characteristics of women presenting severe congenital FXIII deficiency in France, to focus on gynecological and obstetrical events, and to report the management of these rare situations. METHODS We conducted a retrospective study in the French Hemophilia Comprehensive Care and Clinical Hemostasis Centers. Women between 15 and 65 years with factor XIII activity <10 IU dL-1 were included. Biological, clinical and therapeutic events that occurred to these patients during their gynecological and obstetrical period were recorded. RESULTS Among 31 centers, eleven patients were included. The median age at diagnosis was 1.5 years (range: 0-35), and at inclusion it was 30 years (range: 15-63). Fetal miscarriage was the primary manifestations in 2 (18%) patients, the remaining were diagnosed during hemorrhage. Menorrhagias were reported by 2 women (27%), 13 pregnancies were reported by 9 women including one abortion. Every pregnancy was conducted under factor XIII substitution, no hemorrhagic episode was reported. Four patients (36%) experienced at least one fetal miscarriage with a total amount of 30 miscarriages with 6 occurring during substitution. CONCLUSION Altogether, our data confirmed the high incidence of miscarriage in women with factor XIII deficiency. Good outcome of pregnancies required prophylaxis in accordance with international guidelines.
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Affiliation(s)
- Lucia Rugeri
- Hospices Civils de Lyon, Unité Hémostase Clinique, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France.
| | | | | | - Yvonne Borg
- Unité Hémostase et Centre Régional de Traitement des maladies Hémorragiques, Institut de Biologie Clinique, Hôpital Charles Nicolle, Rouen, France
| | - Hervé Chambost
- Centre for Bleeding Disorders, Pediatric Haematology Oncology Department, University Hospital La Timone, AP-HM, and Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France
| | | | - Dominique Desprez
- Centre de Traitement de l'Hémophilie, CHU Strasbourg, Strasbourg, France
| | - Annie Harroche
- Hemophilia Care Centre, Hematology Unit, Hôpital Universitaire Necker Enfants Malades, Paris, France
| | - Vanessa Milien
- FranceCoag, University Hospital La Timone, AP-HM, Marseille, France
| | | | - Sandrine Meunier
- Hospices Civils de Lyon, Unité Hémostase Clinique, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
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Bouttefroy S, Meunier S, Milien V, Boucekine M, Chamouni P, Desprez D, Harroche A, Hochart A, Thiercelin-Legrand MF, Wibaut B, Chambost H, Rugeri L. Congenital factor XIII deficiency: comprehensive overview of the FranceCoag cohort. Br J Haematol 2019; 188:317-320. [PMID: 31414482 DOI: 10.1111/bjh.16133] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Accepted: 06/13/2019] [Indexed: 11/28/2022]
Abstract
This FranceCoag network study assessed 33 patients with congenital factor XIII (FXIII) deficiency presenting FXIII levels <10 iu/dl. Diagnosis was based on abnormal bleeding in 29 patients, a positive family history in 2, recurrent miscarriages in 1 and was fortuitous in 1. Eighteen patients (62·1%) presented life-threatening umbilical or intracranial haemorrhages (ICH). Seven of the 15 patients who experienced ICH were diagnosed but untreated, including 3 with secondary neurological sequelae. All pregnancies without prophylaxis (26/26) led to miscarriages versus 3/16 with prophylaxis. In patients exhibiting FXIII levels <10 iu/dl, prophylaxis could be discussed at diagnosis and at pregnancy. Further controlled prospective studies are needed.
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Affiliation(s)
- Séverine Bouttefroy
- Hospices Civils de Lyon - Unite d'Hemostase Clinique, Hôpital Cardiologique Louis Pradel, Lyon, France
| | - Sandrine Meunier
- Hospices Civils de Lyon - Unite d'Hemostase Clinique, Hôpital Cardiologique Louis Pradel, Lyon, France
| | | | | | - Pierre Chamouni
- Hemophilia Care Center, Rouen University Hospital, Rouen, France
| | - Dominique Desprez
- Haemophilia Treatment Centre, Strasbourg University Regional Hospital, Strasbourg, France
| | - Annie Harroche
- Haemophilia Treatment Centre, APHP, Hospital Necker, Paris, France
| | - Audrey Hochart
- Haematology and Transfusion, CHU Lille, Hospital Necker, Lille, France
| | | | - Bénédicte Wibaut
- Haematology and Transfusion, CHU Lille, Hospital Necker, Lille, France
| | - Hervé Chambost
- AP-HM, FranceCoag, Marseille, France.,Hemophilia Care Center, La Timone Hospital and Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France
| | - Lucia Rugeri
- Hospices Civils de Lyon - Unite d'Hemostase Clinique, Hôpital Cardiologique Louis Pradel, Lyon, France
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3
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Menegatti M, Palla R, Bucciarelli P, Peyvandi F. Minimal factor XIII activity level to prevent major spontaneous bleeds: reply. J Thromb Haemost 2017; 15:2280-2282. [PMID: 28926188 DOI: 10.1111/jth.13851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M Menegatti
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and Luigi Villa Foundation, Milan, Italy
| | - R Palla
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and Luigi Villa Foundation, Milan, Italy
| | - P Bucciarelli
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and Luigi Villa Foundation, Milan, Italy
| | - F Peyvandi
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and Luigi Villa Foundation, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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