Acquired factor V inhibitors: a systematic review

Abstract

The occurrence of an inhibitor against coagulation factor V (FV) is a rare but challenging condition, which may span from asymptomatic laboratory abnormalities to potentially life-threatening bleeding. The onset of FV inhibitors has been associated most frequently in the past with the patients' exposure to topical bovine thrombin administered during surgery procedures. However, since this preparation is no longer used, in this systematic review we have only focused on non-bovine thrombin-related FV inhibitor cases.

Acquired factor V inhibitor in a patient receiving venous-venous extracorporeal membrane oxygenation for Legionella pneumonia

“…3 Overall, 81% of cases had bleeding, and the mucous membranes of most frequently reported sites including gastro-intestinal tract, genito-urinary tract, and the airway were noted in up to 62% of cases. 3 Cerebral haemorrhage occurred in only 8% of cases, but was associated with 50% mortality. 3 Some cases were associated with thrombotic complications rather than haemorrhage.…”

“…3 Cerebral haemorrhage occurred in only 8% of cases, but was associated with 50% mortality. 3 Some cases were associated with thrombotic complications rather than haemorrhage. 5 Laboratory findings included a prolonged prothrombin time and APTT that failed to be corrected by mixing studies.…”

“…1 In acquired cases, it is related to the presence of factor V inhibitor. 3 In one case series of 78 patients, the commonest cause was the use of antibiotics (42%), including β-lactam antibiotics, aminoglycosides, cephalosporins, tetracyclines, and quinolones. The next common cause was surgical procedure (31%) with exposure to bovine thrombin, which is a topical haemostatic agent widely used in cardiovascular or neurosurgical procedures.…”

“…About 16 (21%) cases had no identifiable causes. 3 The median age of presentation was 69 years, with a tendency for male predominance. 3 Overall, 81% of cases had bleeding, and the mucous membranes of most frequently reported sites including gastro-intestinal tract, genito-urinary tract, and the airway were noted in up to 62% of cases.…”

“…3 The median age of presentation was 69 years, with a tendency for male predominance. 3 Overall, 81% of cases had bleeding, and the mucous membranes of most frequently reported sites including gastro-intestinal tract, genito-urinary tract, and the airway were noted in up to 62% of cases. 3 Cerebral haemorrhage occurred in only 8% of cases, but was associated with 50% mortality.…”