Doctors at Wadia Hospital treat a patient with Factor VII- A rare blood clotting disorder

5-year-old Deepika Yadav with a very rare blood clotting disorder was successfully treated for Brachial Plexus at Wadia Hospital.

Karnataka resident, Yadav was suffering from Factor VII deficiency which is considered to be one of the rarest bleeding disorders and the combination of Factor VII deficiency and brachial plexus injury is very uncommon.

Deepika was not able to lift her right arm above the shoulder and when MRI scans were completed, it showed that she had a posterior dislocation of the humeral head. She was advised surgery on the right shoulder by shoulder muscle transfer.

During a routine workup investigation for surgery, it was revealed that a persistent deranged bleeding profile (prolonged Prothrombin time) was not corrected even on medication. After further thorough evaluation by the team at Wadia, it was notified that Deepika had a disorder in which Factor VII was deficient.

We at Wadia Hospital are always ready to take such a challenge to operate and treat such cases. This case was one of its kind and the rarest one. Fewer than 200 cases of such cases are reported globally till date and our medical team has successfully performed once again,” said Dr Minnie.

The hematologists advised Factor VII administration whose cost was very expensive. A 1 mg vial of rNOVO7 costs ₹48,000 and as per an estimate by hematologists, she would require at least 18-19 vials which cost ₹9,00,000 approximately. Due to financial constraints of the labourer father who had six dependents the surgery was deferred. 

Dr. Minnie Bodhanwala, CEO, Wadia Hospitals said,

After consultation with the hematologists of Wadia Hospital, they played a vital role in making a protocol for the surgery. This surgery was performed under cover of Factor VII infusion (rNOVO7) uneventfully. The rNOVO7 was given every 4th hourly for the 48 hours and then reduced to 8th hourly after that. It has now been stopped and there is no bleeding. Without this treatment, she would have bled uncontrollably, and surgery would have been impossible for this child. This child needed corrective surgery to reconstruct the shoulder, or which would result in an inability to use the arm.”

Deepika’s Father said,

We had approached many hospitals in Karnataka but was unsuccessful in our endeavor. BJ Wadia hospital stepped up to this challenge and treated my daughter free of cost and we are very grateful to them”.

What is Brachial Plexus?

The brachial plexus is a network of nerves that send signals from your spine to your shoulder, arm, and hand. A brachial plexus injury occurs when these nerves are stretched, compressed, or in the most serious cases, ripped apart or torn away from the spinal cord. Babies sometimes sustain brachial plexus injuries during birth.

What is Factor VII deficiency?

Factor VII deficiency is a blood clotting disorder that causes excessive or prolonged bleeding after an injury or surgery. With factor VII deficiency, one’s body either doesn’t produce enough factor VII, or something is interfering with factor VII, often another medical condition. Factor VII is a protein produced in the liver that plays an important role in helping one’s blood to clot. It’s one of about 20 clotting factors involved in the complex process of blood clotting.