Management of a patient with factor X deficiency with FEIBA: a case report

Hereditary factor X (FX) deficiency is a rare autosomal recessive disorder that increases bleeding tendencies, ranging from epistaxis to intracranial haemorrhage (ICH), which can be life-threatening. Single factor concentrates are recommended for treating rare bleeding disorders; however, in India m...

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Main Authors: Borboruah Luish, Dutta Anupam
Format: Article
Language:English
Published: Sciendo 2023-08-01
Series:The Journal of Haemophilia Practice
Subjects:
Online Access:https://doi.org/10.2478/jhp-2023-0012
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author Borboruah Luish
Dutta Anupam
author_facet Borboruah Luish
Dutta Anupam
author_sort Borboruah Luish
collection DOAJ
description Hereditary factor X (FX) deficiency is a rare autosomal recessive disorder that increases bleeding tendencies, ranging from epistaxis to intracranial haemorrhage (ICH), which can be life-threatening. Single factor concentrates are recommended for treating rare bleeding disorders; however, in India most people with FX deficiency are treated with fresh frozen plasma (FFP). We report a case of FX deficiency in a child with a history of intracranial bleeding who was found to have a novel mutation in the F10 gene. Although managed with weekly prophylactic FFP infusions, he continued to experience regular bleeding including two further instances of ICH. Other therapeutic options were unavailable or unaffordable. When the Indian Government added FEIBA to the essential drug list, a decision was made to try FEIBA prophylaxis to better manage his bleeding. In 2019, he was started on a weekly dose of FEIBA, 500 IU (20 IU/ kg and his prophylactic FFP transfusion regimen was stopped. His bleeding episodes started to reduce after two months of starting FEIBA prophylaxis. Over the last three years he has had only four minor bleeding episodes and has remained completely free of major bleeding. He is now able to receive home-based therapy and his prognosis can be considered to be improved. FEIBA may be a useful medicinal therapy for FX-deficient patients who suffer severe haemorrhagic episodes in countries where plasma-derived factor X (pdFX) is not available.
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spelling doaj.art-7272ec6bebcf4693a715acf70b96dee92024-01-16T07:20:03ZengSciendoThe Journal of Haemophilia Practice2055-33902023-08-01101687310.2478/jhp-2023-0012Management of a patient with factor X deficiency with FEIBA: a case reportBorboruah Luish0Dutta Anupam1Assam Medical College and Hospital, Dibrugarh, IndiaAssam Medical College and Hospital, Dibrugarh, IndiaHereditary factor X (FX) deficiency is a rare autosomal recessive disorder that increases bleeding tendencies, ranging from epistaxis to intracranial haemorrhage (ICH), which can be life-threatening. Single factor concentrates are recommended for treating rare bleeding disorders; however, in India most people with FX deficiency are treated with fresh frozen plasma (FFP). We report a case of FX deficiency in a child with a history of intracranial bleeding who was found to have a novel mutation in the F10 gene. Although managed with weekly prophylactic FFP infusions, he continued to experience regular bleeding including two further instances of ICH. Other therapeutic options were unavailable or unaffordable. When the Indian Government added FEIBA to the essential drug list, a decision was made to try FEIBA prophylaxis to better manage his bleeding. In 2019, he was started on a weekly dose of FEIBA, 500 IU (20 IU/ kg and his prophylactic FFP transfusion regimen was stopped. His bleeding episodes started to reduce after two months of starting FEIBA prophylaxis. Over the last three years he has had only four minor bleeding episodes and has remained completely free of major bleeding. He is now able to receive home-based therapy and his prognosis can be considered to be improved. FEIBA may be a useful medicinal therapy for FX-deficient patients who suffer severe haemorrhagic episodes in countries where plasma-derived factor X (pdFX) is not available.https://doi.org/10.2478/jhp-2023-0012factor x deficiencyfresh frozen plasma (ffp)feibaintracranial haemorrhagecase report
spellingShingle Borboruah Luish
Dutta Anupam
Management of a patient with factor X deficiency with FEIBA: a case report
The Journal of Haemophilia Practice
factor x deficiency
fresh frozen plasma (ffp)
feiba
intracranial haemorrhage
case report
title Management of a patient with factor X deficiency with FEIBA: a case report
title_full Management of a patient with factor X deficiency with FEIBA: a case report
title_fullStr Management of a patient with factor X deficiency with FEIBA: a case report
title_full_unstemmed Management of a patient with factor X deficiency with FEIBA: a case report
title_short Management of a patient with factor X deficiency with FEIBA: a case report
title_sort management of a patient with factor x deficiency with feiba a case report
topic factor x deficiency
fresh frozen plasma (ffp)
feiba
intracranial haemorrhage
case report
url https://doi.org/10.2478/jhp-2023-0012
work_keys_str_mv AT borboruahluish managementofapatientwithfactorxdeficiencywithfeibaacasereport
AT duttaanupam managementofapatientwithfactorxdeficiencywithfeibaacasereport