{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T10:11:41Z","timestamp":1775815901333,"version":"3.50.1"},"reference-count":14,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T00:00:00Z","timestamp":1704412800000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Key Clinical Message<\/jats:title><jats:p>Acquired inhibitors of blood coagulation are rare but of clinical importance. Prothrombin is a vitamin K\u2010dependent protein, and acquired antibodies toward prothrombin are often associated with the presence of lupus anticoagulant. We describe a previously healthy 70\u2010year\u2010old man presenting with both hemorrhage and thrombosis as well as a prolonged prothrombin time. At arrival at the hospital, he was diagnosed with deep venous thrombosis, and an enlarged lymph node in the left groin was noted (revealed as follicular lymphoma grade 1 by biopsy). Prothrombin activity and antibody titer were followed for 5\u2009months with 15 sampling time points to monitor the treatment outcome of the patient. Diagnostic work\u2010up identified prothrombin deficiency as cause of bleeding. A nonneutralizing calcium\u2010dependent antiprothrombin antibody was found, suspected to increase the clearance of prothrombin, which has previously only occasionally been reported. Lupus anticoagulant was ruled out and thrombosis was judged to be caused by a combination of malignant disease and stagnant venous flow following enlarged lymph nodes in the groin. This report illustrates how investigation of prolonged global coagulation tests, triggered the diagnosis of a rare but critical condition, immune\u2010mediated prothrombin deficiency. The diagnosis is challenging and involves proper differential diagnosis.<\/jats:p>","DOI":"10.1002\/ccr3.8400","type":"journal-article","created":{"date-parts":[[2024,1,6]],"date-time":"2024-01-06T03:44:21Z","timestamp":1704512661000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A nonneutralizing antibody as cause of prothrombin deficiency in a patient with follicular lymphoma"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5587-3712","authenticated-orcid":false,"given":"Cecilia","family":"Augustsson","sequence":"first","affiliation":[{"name":"Division of Laboratory Medicine, Coagulation, Department of Clinical Chemistry and Pharmacology University and Regional Laboratories Region Sk\u00e5ne  Malm\u00f6 Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Knut","family":"Taxbro","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Medicine Ryhov County Hospital  J\u00f6nk\u00f6ping Sweden"},{"name":"Department of Biomedical and Clinical Sciences University of Link\u00f6ping  Link\u00f6ping Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karin","family":"Strandberg","sequence":"additional","affiliation":[{"name":"Division of Laboratory Medicine, Coagulation, Department of Clinical Chemistry and Pharmacology University and Regional Laboratories Region Sk\u00e5ne  Malm\u00f6 Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Zetterberg","sequence":"additional","affiliation":[{"name":"Centre for Thrombosis and Haemostasis Sk\u00e5ne University Hospital  Malm\u00f6 Sweden"},{"name":"Department of Translational Medicine Lund University  Malm\u00f6 Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,1,5]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00062752-199909000-00009"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V93.7.2149"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11082164"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-012-1737-1"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2005.01478.x"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcla.24276"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH13-06-0509"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH12-07-0527"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-10-116327"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V65.6.1538.bloodjournal6561538"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2008.01671.x"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20010215)91:4<636::AID-CNCR1046>3.0.CO;2-V"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2011.02553.x"},{"key":"e_1_2_11_15_1","first-page":"4","article-title":"Autoimmunity and lymphoma: a brief review","volume":"4","author":"Miller EB","year":"2018","journal-title":"J Rheum Dis Treat"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.8400","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T03:53:19Z","timestamp":1706845999000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.8400"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1002\/ccr3.8400"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.8400","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]},"assertion":[{"value":"2023-09-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e8400"}}