Acquired Coagulation Disorders Caused by Inhibitors

A 75-year-old woman with acquired haemophilia disguised by warfarin treatment

“…The causes of AH are not fully understood, although they are likely to involve a combination of irregularities within the immune system, and a range of environmental and genetic factors 1 2…”

“…Clinical presentation most commonly involves recent onset of abnormal bleeding, which can be severe and life-threatening,3 and is usually spontaneous, but can also present after trauma 1 4. However, the pattern of bleeding seen with AH is often quite different from that of congenital haemophilia.…”

“…In people aged over 85 years, the incidence rises to 14.7 per million 1. Such rarity makes diagnosis and treatment of the condition all the more difficult, given that patients may present in centres with little or no experience of AH, leading to possible delays or suboptimal management.…”

Refractory Epistaxis due to Severe Factor V Deficiency with Inhibitor

“…Treatment is often derived from series of case reports. Most patients with FV inhibitor have specific risk factors such as being exposed to surgical procedures, topical bovine thrombin, antibiotics specifically of the beta lactam group, blood transfusions, cancers, and autoimmune disorders [ 1 , 2 ]. FV deficiency secondary to an inhibitor can occur at any age and has a variable phenotype resulting in a mixed presentation of clinical symptoms and laboratory findings.…”

“…Isolated mutations in F5 gene and combined deficiency in factors V and VIII, as seen in F5F8D, can cause a heterogenous bleeding phenotype. Factor V deficiency is extremely rare affecting 1 : 1,000,000 of the population; inhibitors to this condition can arise from exposure to bovine thrombin, autoimmune etiologies, and beta lactamase exposure and are exceedingly rare [ 1 ]. We describe a case report of our patient with severe factor V deficiency with inhibitor with moderate epistaxis and treatments used for hemostasis.…”