Factor IX deficiency and bleeding in a patient with Sheehan's syndrome.

Factor IX deficiency was associated with a hemorrhagic disorder in a woman who previously had experienced postpartum hypotension resulting in Sheehan’s syndrome. There was no family history of Christmas disease, and other known causes of factor IX deficiency were excluded. Plasma levels of factor IX were partially corrected by therapy with thyroid hormones and completely restored to normal by the administration of cortisone. The response of factor IX to plasma infusion resembled the response of factor VIII in patients with von Willebrand’s disease who receive plasma. Normal hemostasis and levels of factor IX have been maintained by the administration of physiologic dosages of thyroid and adrenal hormones. Blood coagulation was studied in several other patients with pituitary or thyroid dysfunction. All were normal, indicating that this patient represents an unusual example of the effects of an endocrine dysfunction on a single blood coagulation factor.