We present a 34-year-old man with combination of beta thalassemia intermedia and coagulation factor VII deficiency who was presented with pallor and irregular nose bleeding episodes. On physical examination, he had splenomegaly and yellow sclera. Pallor and splenomegaly could be reminder of thalassemic syndromes or hemoglobinopathies including thalassemia intermedia. Association with unusual bleeding tendency such as prolonged and repeated episodes of epistaxis without any evidence of liver failure in hemoglobinopathies suggest the possibility of coinheritance of a bleeding disorder. As a result, coagulation assay for proper diagnosis, management and prevention of probable life-threatening bleeding episodes is suggested.
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