Abstract

Background: Factor XIII deficiency is a rarely encountered bleeding disorder traditionally identified by clot dissolution in 5 molar urea (urea solubility test).
Methods: We report a patient with delayed post-surgical bleeding characteristic of factor XIII deficiency with a normal urea solubility test.
Results: Factor XIII deficiency was identified by an automated assay that measured factor XIII antigen. The patient was successfully treated with cryoprecipitate.
Conclusions: Patients with excessive bleeding with normal screening tests should be tested for factor XIII using a sensitive assay procedure. The urea solubility assay for factor XIII should be discontinued due to its lack of sensitivity.

DOI: 10.7754/Clin.Lab.2014.140517