The Curious Clinicians 121 - The Forgotten Factor
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Jan 8, 2026 Dive into the fascinating story of John Hageman and his mysterious coagulation case from the 1950s. Explore why his prolonged clotting time stumped doctors, eventually leading to the discovery of factor XII. Learn about the peculiar role of this factor in the coagulation cascade and its surprising dispensability in vivo. The conversation also touches on factor XII's potential as a thrombosis prevention tool and its evolutionary significance. Get ready for a captivating blend of medical history and science!
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Hageman Sparked The Cascade
- John Hageman's prolonged clotting time led to discovery of a missing plasma protein now called factor XII.
- That finding helped shape the modern concept of an ordered coagulation cascade.
Unexpected Preop Lab Abnormality
- John Hageman was an asymptomatic 37-year-old found to have a prolonged clotting time before partial gastrectomy.
- He had normal bleeding history and underwent surgery without excessive bleeding.
Mixing Study Revealed A Different Defect
- Mixing Hageman's plasma with plasma from hemophilia patients immediately corrected clotting in vitro.
- That showed his problem was distinct from factor VIII or IX deficiency.