Fibrinolytic Bleeding Complicated by Factor XIII Defect

Three patients with bleeding attributed to acquired fibrinolysis and functional deficiency of factor XIII are reported. Hepatic abnormalities were present in two patients. In one patient the factor XIII assay improved as hepatic function tests returned to normal. Two patients received therapy to reduce fibrinolytic activity. The improvement of the euglobulin lysis time and factor XIII assay in these patients coincided with therapy. We propose that each defect contributed to the expression of the other. The presence of fibrinolysis should occasion a search for functional factor XIII deficiency when liver disease is present.