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Medical Science Monitor Basic Research


Recurrent Post Tonsillectomy Secondary Hemorrhage in Patients with Factor XIII Deficiency: A Case Series and Review of Literature

Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Rare disease

Hassen Mohammed, Zaid Abu Rajab ALtamimi, Rashid Sheikh, Hayam Al Taweel, Shanmugam Ganesan

Qatar Department of Otorhinolaryngology and Head & Neck Surgery (ORL-HNS), Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar

Am J Case Rep 2016; 17:850-854

DOI: 10.12659/AJCR.900391

Available online:

Published: 2016-11-15

BACKGROUND: Post-tonsillectomy hemorrhage (PTH) has been reported in the literature as a serious complication after tonsillectomy that has high morbidity and can be life threatening. In cases of recurrent secondary PTH, one should consider coagulopathies as the hidden pathology. Factor XIII deficiency is very rare, suggested to be present 1 in 2 million people. Patients with undiagnosed factor XIII deficiency with secondary PTH are extremely rare. 
CASE REPORT: We report on the cases of six patients (four adults and two children) who presented with recurrent attacks of secondary PTH.
CONCLUSIONS: Recurrent, severe PTH could be related to undiagnosed hematological disorders.

Keywords: Factor XIII Deficiency, Hemorrhage, Tonsillectomy