Stuart Factor (Factor X) Deficiency Associated with Renal and Adrenal Cortical Insufficiency

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Abstract
A patient with findings of combined adenocarcinoma of the kidney and of adrenal cortical carcinoma proven by surgical exploration and by histologic findings showed hypoprothrombinemia on routing preoperative evaluation of unexplained hematuria. Further analysis of the hypoprothrombinemia indicated a mild deficiency of Stuart factor (Factor X), only slightly corrected by the administration of vitamin K and blood. Other clotting factors seemed normal and no anticoagulant was present. Ten days after removal of both tumors the hypoprothrombinemia had remitted. The plasma prothrombin time remained normal 6 mo. after the surgical procedure. Vanillylmandelic acid was elevated in urine prior to and remained elevated after surgery. Liver functions tests and liver biopsy specimen appeared normal. The hypothesis is presented that the acquired deficiency of Stuart factor might have been related to hormonal influences connected with the presence of the 2 malignant tumors.

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