{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T05:10:03Z","timestamp":1779426603353,"version":"3.53.1"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Factor XIII (FXIII) deficiency is a rare yet potentially life-threatening bleeding disorder, which typically manifests with normal results on routine coagulation assays: a key factor contributing to its frequent underdiagnosis. People living with HIV (PLWH) are predisposed to hemostatic abnormalities; however, the coexistence of HIV infection and a possible acquired FXIII deficiency has been rarely documented in the literature. Herein, we describe a rare case of suspected acquired FXIII deficiency in an HIV-positive man with a well-controlled infection on long-term antiretroviral therapy (ART), who presented with recurrent spontaneous bleeding that led to spontaneous splenic rupture and delayed postoperative hemorrhage. A clot solubility test (CST) demonstrated complete dissolution of the fibrin clot within 24\u202fh, indicating the possibility of FXIII deficiency. Based on clinical manifestations and limited laboratory data, a diagnosis of suspected acquired FXIII deficiency was formulated. In resource-limited settings, a pragmatic management strategy encompasses on-demand cryoprecipitate replacement, and meticulous perioperative planning. Immunosuppressive therapy was administered in consideration of a potential immune-mediated etiology, yet this intervention failed to resolve the patient\u2019s recurrent spontaneous bleeding.<\/jats:p>","DOI":"10.3389\/fmed.2026.1768171","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T04:55:28Z","timestamp":1779425728000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Suspected acquired factor XIII deficiency in a man living with HIV: diagnostic and therapeutic challenges in recurrent spontaneous hemorrhage: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Wei","family":"He","sequence":"first","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital of Chengdu Medical College","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juecai","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital of Chengdu Medical College","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongwei","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital of Chengdu Medical College","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"931","DOI":"10.1152\/physrev.00016.2010","article-title":"Factor XIII: a coagulation factor with multiple plasmatic and cellular functions","volume":"91","author":"Muszbek","year":"2011","journal-title":"Physiol Rev"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.blre.2016.08.002","article-title":"Autoimmune acquired factor XIII deficiency due to anti-factor XIII\/13 antibodies: a summary of 93 patients","volume":"31","author":"Ichinose","year":"2017","journal-title":"Blood Rev"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"160","DOI":"10.5482\/HAMO-13-08-0046","article-title":"Coagulation factor XIII deficiency. 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