Factor XIa

Pathway · detail · Haemophilia C APTT

Factor XI is activated by XIIa on a contact surface and, more importantly in vivo, by thrombin itself — a feedback loop that sustains factor IX activation once clotting is under way. It is the point at which the contact system stops being a laboratory curiosity and starts to matter clinically.

Traced from the start

  1. Contact activation system (factor XII, prekallikrein, high-molecular-weight kininogen)
  2. Factor XIa

Detail

Activated by
Factor XIIa, and by thrombin as feedback amplification
Activates
Factor IX to IXa
Measured by
APTT and a factor XI activity assay
Drug target
Factor XI inhibitors (abelacimab, milvexian, asundexian) aim to prevent thrombosis while sparing haemostasis, since XI deficiency bleeds only mildly

When it goes wrong

Factor XI deficiency (haemophilia C), autosomal and strongly enriched in Ashkenazi Jewish populations

Injury-related rather than spontaneous bleeding, especially after tonsillectomy, dental extraction and urological or obstetric surgery; bleeding correlates poorly with the factor level. Prolonged APTT with a normal PT

Practise this structure

No question in the bank is tagged to Factor XIa yet. Questions appear here automatically once one is — the question bank is free to browse in the meantime.