Factor XIII Supplementation Suppresses Recurrent Hemorrhages Due to Acquired Factor XIII Deficiency Secondary to Severe Acute Pancreatitis: A Case Report

Hemorrhagic complications associated with severe acute pancreatitis significantly worsen the prognosis. Acquired factor XIII (FXIII) deficiency can lead to delayed tissue repair and associated recurrent bleeding, yet its clinical impact in the context of pancreatitis remains poorly understood. A 69-year-old woman with severe acute pancreatitis developed recurrent hemorrhagic shock due to multiple arterial bleeding episodes, including the splenic and left gastric arteries. Despite repeated transcatheter arterial embolization and massive blood transfusions, hemorrhagic events recurred during the subacute phase. Laboratory investigations revealed an acquired FXIII deficiency with FXIII activity levels of 56-59%. Repeated administration of FXIII concentrates administration suppresses the hemorrhagic complications gradually. This report suggests that FXIII concentrate administration may be a beneficial therapeutic option for managing recurrent hemorrhagic complications and stabilizing the clinical course in patients with severe acute pancreatitis and acquired FXIII deficiency.