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. 2020 Dec 23;4(4):e457-e462.
doi: 10.1055/s-0040-1721500. eCollection 2020 Oct.

Prevalence of Coagulation Factors Deficiency among Young Adults in Saudi Arabia: A National Survey

Khalid A AlSaleh  1 , Nouf Al-Numair  2 , Ayman AlSuliman  3 , Mohammed Zolaly  4 , Abdul Majeed Albanyan  5 , Nouf AlOtaishan  2 , Esra Abudouleh  5 , Nervana Bayoumy  6 , Ahmad Tarawah  7 , Faisal AlZahrani  8 , Faisal AlAllaf  9 , Abdul Kareem AlMomen  10 , Raihan Sajid  11 , Tarek M Owaidah  12
Affiliations

Prevalence of Coagulation Factors Deficiency among Young Adults in Saudi Arabia: A National Survey

Khalid A AlSaleh et al. TH Open. .

Abstract

Introduction Inherited bleeding disorders vary in prevalence due to genetic disparity and ethnicity. Little is known about the prevalence of coagulation factor deficiency and bleeding disorders in middle-eastern population. Methods Young Saudi adults with at least one positive bleeding symptom reported in semi-structured validated condensed MCMDM-1vWD questionnaire were tested for complete blood count, routine and special coagulation tests, serum ferritin level, and capillary zone electrophoresis. After initial testing, those with prolonged prothrombin time (PT) or activated prothrombin time (APTT) had further testing to evaluate coagulation factors level. Platelet function was tested through platelet function analyzer (PFA)-100, and multiplate aggregometer (MEA) on patients suspected of having platelet disorders. Results Six-hundred-forty patients (male = 347, 54.2%) were included. A possible platelet function defect was diagnosed in three patients with one matching Glanzmann's thrombasthenia trait pattern, and one that of Bernard-Soulier trait pattern. One patient was diagnosed with von Willebrand disease. Deficiencies in coagulation factor levels were revealed as F-VIII in 14 (7.4%), F-IX in 15 (7.6%), F-II in two (3.3%), F-V in 17 (26.1%), FVII in two (3.1%), and F-X in one (1.8%) of study subjects; low vWF activity (<50%) was found in 14 (8%). Abnormal values were found for various laboratory tests with prolongation of platelet function analyzer-epinephrine (PFA-EPI) in 11%, PFA-ADP or arachidonic acid in 15.2%, PT in 35.9%, and APTT in 63.7%. Five-hundred-seventy-six patients (90%) had normal results in the coagulation factor assays and were categorized as patients with bleeding of unknown cause (BUC). A diagnosis of a bleeding disorder was more frequently made in men than in women (38 vs. 26). Iron deficiency anemia was found in 18 (25%) females positively associated with F-IX deficiency ( p -value 0.000). Male gender (73.3%, p = 0.007) was independently associated with the diagnosis of coagulation factor deficiency. Conclusion The current study reports a higher prevalence of coagulation factors deficiency in Saudi population than reported in the western population.

Keywords: bleeding; coagulation; inherited.

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Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
Factors deficiency in males.
Fig. 2
Fig. 2
Factor deficiency in females.
See this image and copyright information in PMC

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