A female with no previous history of bleeding presented with active bleeding from multiple body sites, declining hemoglolobin levels, and markedly prolonged prothrombin times (PT), and activated partial thromboplastin times (APTT) with incomplete correction on PT mix assays. This patient showed a severe deficiency of factor X. FX levels and bleeding were refractory to multiple transfusions of fresh frozen plasma. Although plasmapheresis was started with concomitant intravenous immunoglobulin and steroid therapy, the patient died.