Acquired Factor V Inhibitor Responsive to Corticosteroids in a Patient with Double Cancers

Endo, Hitoshi; Kawauchi, Kiyotaka; Tomimatsu, Masahiko; Iga, Daijiro; Ogasawara, Toshie; Yasuyama, Masako; Saito, Toshihito; Otsuka, Kuniaki; Aiba, Motohiko

doi:10.2169/internalmedicine.46.6390

Cited by 14 publications

(11 citation statements)

References 17 publications

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“…In general, the prognosis of AFVI depends on the underlying disease inducing the AFVI [7,11], and it is important to screen the patients for malignancies [11]. In the present patient, a detailed whole-body examination revealed no malignancies.…”

Section: Discussionmentioning

confidence: 63%

Acquired Factor V Inhibitor Developing after Treatment with Dabigatran Etexilate Methanesulfonate: A Case Report and Review of the Literature

Sekiguchi

Yoshikawa

Shimada

et al. 2014

Indian J Hematol Blood Transfus

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A 90-year-old man presented with subcutaneous ecchymoses. He had been under treatment with dabigatran etexilate methanesulfonate (DEM). Prolonged APTT and decreased PT was developed 2 months after the start of DEM, more prolonged 6 months later. DEM was discontinued, the coagulopathy did not improve. Factor V activity was decreased, along with appearance of coagulation factor V inhibitor (FVI). He did not have antiphospholipid syndrome or malignancy. He was diagnosed as having acquired FVI caused by DEM. Steroid pulse therapy was effective. There have been 74 reported cases of AFVI induced by drug treatment, but none after treatment with DEM.

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Section: Discussionmentioning

confidence: 63%

Acquired Factor V Inhibitor Developing after Treatment with Dabigatran Etexilate Methanesulfonate: A Case Report and Review of the Literature

Sekiguchi

Yoshikawa

Shimada

et al. 2014

Indian J Hematol Blood Transfus

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“…A previous study demonstrated that coagulation tests such as PT, FV activity or inhibitor titer are of little help in identifying which patients are likely to bleed (2), indicating her probability of bleeding was not estimated. We used prednisolone following the anecdotal treatment experiences of other investigators (2,8). We judged that the benefit of prednisolone administration surpassed its drawbacks, but we do not know whether this judgment was correct.…”

Section: Discussionmentioning

confidence: 99%

Acquired Factor V Inhibitor in a Patient with a Mechanical Aortic Valve under Warfarin Therapy

Nozu¹,

Mitsuya²,

Okumura

2010

Intern. Med.

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An 84-year-old woman under warfarin therapy, who had undergone mechanical valve replacement 29 months previously, developed coagulation abnormalities after antibiotic treatment for pyelonephritis. Laboratory findings included PT at 47.6 sec, activated thromboplastin time (APTT) at 147 sec, factor V (FV) activity of 4% and FV inhibitor of 8 BU. Although overt bleeding was not observed, administration of prednisolone was started. Her coagulation abnormalities were rapidly normalized. It was later determined that the patient had received bovine thrombin at surgery. The presence of a FV inhibitor should be considered in the differential diagnosis in patients demonstrating an unexpected prolongation of PT under warfarin therapy following surgery.

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“…The present case of acquired FV inhibitor is unusual due to coexistence of several factors known to predispose to the generation of this rare inhibitor, namely nephrotic syndrome with HBV infection [8], elevated antinuclear antibodies, massive blood product transfusions and urgent surgery complicated with anuria requiring several haemodialysis sessions. To our knowledge, no similar cases have been reported yet.…”

mentioning

confidence: 89%

“…The spectrum of clinical manifestations of this inhibitor ranges from mild to life-threatening bleeding [2]. The known risk factors for acquired FV inhibitor are multiple blood transfusions, trauma and surgery [4,5], use of antibiotics [5], autoimmune disorders [6], malignancy [7,8], hepatic disorders [8] and bovine thrombin exposure [9]. We present here a female patient who developed FV inhibitor following emergency aortic aneurysm surgery.…”

mentioning

confidence: 99%

Acquired factor V inhibitor in a woman following aortic aneurysm surgery

Siekańska-Cholewa

Jarosz

Góralczyk

et al. 2014

Blood Coagulation &Amp; Fibrinolysis

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A 67-year-old woman with nephrotic syndrome as a complication of membranous glomerulonephritis associated with chronic active hepatitis B virus infection developed factor V inhibitor following emergency aortic aneurysm surgery followed by massive blood transfusions and haemodialysis. On the second postoperative day, prothrombin time and activated partial thromboplastin time increased and were unresponsive to fresh frozen plasma. Epistaxis and urethral bleeding were observed, followed by mucosal mouth bleeding. A very low factor V activity less than 5% was found and a factor V inhibitor was detected at 7.76 Bethesda Units. Treatment with corticosteroids was successful. In this patient, several conditions known to predispose to the generation of factor V inhibitor occurred simultaneously. Four months later, factor V inhibitor (225 Bethesda Units) recurred and the patient died of intracerebral haemorrhage.

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Acquired Factor V Inhibitor Responsive to Corticosteroids in a Patient with Double Cancers

Abstract: Abstract

Cited by 14 publications

References 17 publications

Acquired Factor V Inhibitor Developing after Treatment with Dabigatran Etexilate Methanesulfonate: A Case Report and Review of the Literature

Acquired Factor V Inhibitor Developing after Treatment with Dabigatran Etexilate Methanesulfonate: A Case Report and Review of the Literature

Acquired Factor V Inhibitor in a Patient with a Mechanical Aortic Valve under Warfarin Therapy

Acquired factor V inhibitor in a woman following aortic aneurysm surgery

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