Acquired factor XII deficiency in a woman with recurrent pregnancy loss: working on a differential diagnosis in a single
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BioMed Central
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Acquired factor XII deficiency in a woman with recurrent pregnancy loss: working on a differential diagnosis in a single case Maristella D'Uva, Ida Strina, Antonio Mollo, Antonio Ranieri, Giuseppe De Placido and Pierpaolo Di Micco* Address: Dipartimento Universitario di Scienze Ostetriche Ginecologiche e Medicina della Riproduzione, Area Funzionale di Medicina della Riproduzione ed Endoscopia Ginecologica, Università degli Studi di Napoli Federico II, via Pansini 5 Building 9, 80131, Naples, Italy; *Thrombosis Center, Istituto Clinico Humanitas "IRCCS", via Manzoni 56, 20089, Rozzano – Milano – Italy Email: Maristella D'Uva - [email protected]; Ida Strina - [email protected]; Antonio Mollo - [email protected]; Antonio Ranieri - [email protected]; Giuseppe De Placido - [email protected]; Pierpaolo Di Micco* - [email protected] * Corresponding author
Published: 02 December 2005 Journal of Translational Medicine 2005, 3:43
doi:10.1186/1479-5876-3-43
Received: 05 October 2005 Accepted: 02 December 2005
This article is available from: http://www.translational-medicine.com/content/3/1/43 © 2005 D'Uva et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Antiphospholipid syndrome (APS) has been often associated to RPL since 1980 and some reports in the Literature rarely described antibodies to factor XII in patients with APS. Case history: We report the case history of 34-year-old caucasian women with recurrent fetal loss and persistent prolonged activated partial thromboplastin time. Haemostatic tests revealed persistent light decrease of clotting factor XII with normal values of IgG and IgM anticardiolipin antibodies and transient positivity for lupus anticoagulant (LA). Few reports in the Literature described antibodies to factor XII in patient with antiphospholipid syndrome (APS) and transient LA. So, once other causes of RPL were excluded, the patient was diagnosed an unusual form of APS associated to antibodies to factor XII, reduced factor XII plasma levels, transient LA and prolonged activated partial thromboplastin time. Discussion: We suggest to consider also antibodies directed to clotting factors (e.g. factor XII in our case) as second step of thrombophilia screening in RPL, in particular if a persistent prolonged aPTT is present without an apparent cause.
Background Recurrent pregnancy loss (RPL) is one of the most common cause of sterility. An our recent study underlined the relevant role of d-dimer, as marker of hypercoagulable state, to identify thrombophilia in women affected by primary or secondary sterility [1] In 1999 a study written by Brenner et al. identified thrombophilia as principal cause of more than 40% of women affected by RPL [2]. Further studies underlined a pathogenetic
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