{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T07:56:12Z","timestamp":1774511772198,"version":"3.50.1"},"reference-count":11,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Factor XIII deficiency is a rare cause of bleeding disorder. An 8\u2010month\u2010old male infant presented with persistent bleeding from a minor lip cut injury, which was sustained 2\u2009days prior. The bleeding did not stop despite local hemostatic measures. His medical history was notable for spontaneous intradermal bleeds at different times and umbilical stump bleeding during the neonatal period. On examination, there were multiple petechiae and a large ecchymosis over the chest. Routine hematological and coagulation parameters were within normal limits. von Willebrand factor, factor VIII, and factor IX levels were normal. However, a qualitative 5M urea clot solubility test followed by factor XIII assay yielded abnormal results, confirming factor XIII deficiency. The patient was managed with fresh frozen plasma (FFP) and supportive care. Four\u2009months later, the patient presented with lethargy and vomiting, later diagnosed as epidural hematoma. The patient received FFP, had a favorable stay in the pediatric intensive care unit, and was discharged with no neurological deficits and a prophylactic plan. This case underscores how factor XIII deficiency can elude detection in routine coagulation tests, emphasizing the importance of prompt diagnosis and timely administration of replacement therapy to prevent complications and associated constraints in a resource limited setting.<\/jats:p>","DOI":"10.1002\/ccr3.72193","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T16:55:00Z","timestamp":1772988900000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factor\n                    <scp>XIII<\/scp>\n                    Deficiency: A Silent Bleeder Behind a Normal Coagulation Profile"],"prefix":"10.1002","volume":"14","author":[{"given":"Ramesh","family":"Yadav","sequence":"first","affiliation":[{"name":"Department of Paediatrics Birat Medical College Teaching Hospital  Morang Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madhav Raj","family":"Karki","sequence":"additional","affiliation":[{"name":"Birat Medical College Teaching Hospital  Morang Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9549-9435","authenticated-orcid":false,"given":"Dikshya","family":"Pokhrel","sequence":"additional","affiliation":[{"name":"Birat Medical College Teaching Hospital  Morang Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9142-9661","authenticated-orcid":false,"given":"Aron","family":"Neupane","sequence":"additional","affiliation":[{"name":"Birat Medical College Teaching Hospital  Morang Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1524-4491","authenticated-orcid":false,"given":"Kshitiz","family":"Parajuli","sequence":"additional","affiliation":[{"name":"Birat Medical College Teaching Hospital  Morang Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5060-2611","authenticated-orcid":false,"given":"Hem Sagar","family":"Rimal","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Birat Medical College Teaching Hospital  Morang Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,6]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.12756"},{"issue":"5","key":"e_1_2_13_3_1","doi-asserted-by":"crossref","DOI":"10.1097\/EA9.0000000000000035","article-title":"Acquired Factor XIII Deficiency","volume":"2","author":"Olivier Duranteau O.","year":"2023","journal-title":"European Journal of Anaesthesiology Intensive Care"},{"key":"e_1_2_13_4_1","volume-title":"Factor XIII Deficiency","author":"Mangla A.","year":"2022"},{"issue":"9","key":"e_1_2_13_5_1","first-page":"565","article-title":"Factor XIII Deficiency in 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Hemostasis"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0b013e31828e52b6"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.1999.01648.x"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41232-022-00252-4"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2022-248743"}],"container-title":["Clinical Case 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