Low Value of Activated Coagulation Factor VII in Young Primary Spontaneous Pneumothorax

Abstract

Objectives: We previously reported a young patient with a primary spontaneous pneumothorax who had a blood coagulation disorder that was not associated with a clinical bleeding tendency. Many of these patients showed an abnormal prothrombin time (PT). We decided to investigate the relationship between activated coagulation factor VII (FVIIa) and PT abnormalities. Methods: The clinical records of patients treated for primary spontaneous pneumothorax at Sapporo City General Hospital Pneumothorax Center between July 2016 and August 2019 were reviewed retrospectively. Eighteen patients aged 25 years or younger with a spontaneous pneumothorax who had received PT and FVIIa tests during hospitalization were enrolled. The age range of the 17 male and 1 female patients was 13 to 23 years with a mean of 18.2 years. Results: Eleven (61.1%) of the patients had a FVIIa level of <59%. These FVIIa abnormalities were not associated with the degree of the PT abnormality. However, none of the patients showed a bleeding tendency during drainage and surgical procedures. Conclusions: Our results indicate that two-thirds of patients with a PT disorder have a low FVIIa level. However, it remains unknown whether these blood coagulation disorders are related to the onset of a primary spontaneous pneumothorax.