Praveen Kumar Tirlangi: A New Mechanism of Bleeding in Kyasanur Forest Disease
Praveen Kumar Tirlangi, Associate Professor at Kasturba Medical College, shared a post on LinkedIn about a recent article he and his colleagues co-authored, published in Transactions of the Royal Society of Tropical Medicine and Hygiene, adding:
“Abnormal laboratory values can sometimes indicate more than just a laboratory anomaly; they may uncover new disease mechanisms.
Kyasanur Forest Disease (KFD) is a viral hemorrhagic fever known for its bleeding complications.
In patients who experience bleeding, we frequently observe an isolated prolongation of aPTT with a normal PT, yet the underlying mechanism has remained elusive.
In our recently published case series in Transactions of the Royal Society of Tropical Medicine and Hygiene, we delved deeper into this phenomenon.
The breakthrough: We discovered that these patients had developed Factor IX deficiency, leading to an acquired hemophilia B phenotype.
This finding could have significant therapeutic implications.
When a KFD patient presents with bleeding and an isolated prolonged aPTT, the instinct is often to initiate empiric blood component therapy. However, if the root cause is Factor IX deficiency, utilizing Fresh Frozen Plasma (FFP) or Factor IX concentrate, when available, may be a more appropriate replacement strategy than cryoprecipitate, which contains minimal Factor IX.
While the impact of targeted Factor IX replacement on clinical outcomes requires further investigation, identifying the mechanism is a crucial first step toward precision management.
This serves as a reminder that questioning unexpected laboratory results can reveal new dimensions of disease biology.
Proud to share this work from our team.”
Title: Acquired haemophilia B in Kyasanur Forest disease: a case series of isolated prolonged activated partial thromboplastin time
Authors: Nitin Gupta, Sushma Belurkar, Muralidhar Varma, Anjely Sebastian, Chiranjay Mukhopadhyay, Tirlangi Praveen Kumar
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