Prekallikrein (Fletcher Factor) Deficiency and Prolongation of APTT Reaction

摘要

BACKGROUND: Prekallikrein (Fletcher factor) is a protein of the contact phase of the blood coagulation system. A deficiency is a very rare event. The clinical meaning is still unknown. CASE REPORT: In a 24-year-old patient of Croatian nationality, who has never suffered from any kind of proneness to hemorrhage, a considerable prolongation of activated partial thromboplastin time (APTT) was diagnosed preoperatively. The prothrombin time (PT) was normal. The patient had to be subjected to horseshoe-kidney surgery. CLOTTING TESTS: A very seldom Fletcher factor (prekallikrein) deficiency type II was detected. The activity was < 1%, but the prekallikrein concentration was normal, comparable to that in normal plasma. THERAPY AND COURSE: Complications were neither noticed during renal surgery nor postoperatively. The patient did not show clinical symptoms. This fact corroborates reports about similar cases published earlier. CONCLUSION: Nevertheless, attention has to be paid to these exceptionally rare symptoms, as in some publications, thromboembolic or even bleeding complications were reported.