Haemodialysis Tunisian patient with acquired factor V inhibitor associated to arteriovenous shunt thrombosis

Ghachem, Ikbel; Borgi, Wijdene El; Salem, Sarra Fekih; Lakhal, Fatma Ben; Chelbi, Amel; Ghiriani, Iheb; Gouider, Emna

doi:10.1684/abc.2020.1540

Cited by 3 publications

(3 citation statements)

References 17 publications

(26 reference statements)

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“…Hemostatic defect in arteriovenous fistula, which presents as persistent oozing and is a common complication in patients undergoing hemodialysis, was the first symptom in several of these reported cases. In four of the abovementioned patients, hemostatic defect in arteriovenous fistula may be related to antimicrobial therapy (Table 4) [3,[9][10][11][12][13][14][15][16]. Furthermore, AiFVD and eosinophilia were reported in four other patients with renal disease beside our patient [12,[17][18][19].…”

Section: Discussionmentioning

confidence: 65%

Acquired factor V inhibitor with erythema and eosinophilia in a patient with end-stage renal disease

et al. 2022

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Autoimmune factor V deficiency (AiFVD) is a rare bleeding disorder caused by factor V inhibitors. In this report, we present the case of an 89-year-old man who developed bleeding tendency during surgery to create arteriovenous fistula for hemodialysis. The bleeding tendency developed with prolongation of activated partial thromboplastin and prothrombin time, following drug-induced eruption and eosinophilia. Significant reduction in coagulation factor activity and inhibitory pattern in cross-mixing tests suggested the presence of inhibitors to coagulation factors. Subsequently, we detected a factor V inhibitor and anti-factor V autoantibodies was confirmed using enzyme-linked immunosorbent assay with purified human plasma factor V. Thus, the patient was ‘definitely diagnosed’ with AiFVD in accordance with the diagnostic criteria enacted by the Japanese Ministry of Health, Labor, and Welfare. The bleeding tendency improved after initiating oral prednisolone 50 mg (1 mg/kg) followed by normalization of activated partial thromboplastin time and prothrombin time at the 34th day. After improving the coagulation system prolongation, the inhibitor and autoantibodies has been eradicated. Since it is suggested that drug-induced immune response can cause AiFVD, AiFVD should be considered in patients who undergo hemodialysis and develop failure of hemostasis and drug-induced eruption.

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Section: Discussionmentioning

confidence: 65%

Acquired factor V inhibitor with erythema and eosinophilia in a patient with end-stage renal disease

et al. 2022

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“…Two cases reported haemodialysis patients with factor V inhibitors who developed possible thrombotic complications rather than bleeding. 19,20 Further associations have been described in CKD patients on warfarin. One patient presented with gastrointestinal bleeding had an underlying autoimmune disorder and eosinophilia, and was successfully treated with prednisone.…”

Section: Discussionmentioning

confidence: 99%

“…The patient was treated successfully with oral prednisolone. Two cases reported haemodialysis patients with factor V inhibitors who developed possible thrombotic complications rather than bleeding 19,20 …”

Section: Discussionmentioning

confidence: 99%

Idiopathic factor V inhibitor in a patient starting haemodialysis

Sutherland

Tan

Hanna

2022

Internal Medicine Journal

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A 74‐year‐old Pacific Island man with end‐stage renal failure planning to start haemodialysis presented with persistent bleeding after tunnelled dialysis catheter insertion. The laboratory findings revealed a prolonged activated partial thromboplastin time of 118 s, prothrombin ratio of 4.2, factor V activity of <2% and a factor V inhibitor of 40 Bethesda Units. No clear underlying aetiology was identified. The bleeding settled with conservative measures and the factor V inhibitor was successfully treated with oral cyclophosphamide for 6 weeks.

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透析導入後に自己免疫性後天性凝固第ⅴ因子欠乏症を発症し，脳出血を呈した血液透析患者の1例

Ishisaka

Endo

Tamai

et al. 2023

Nihon Toseki Igakkai Zasshi

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Keywords： hemodialysis, acquired factor V inhibitor, cerebral hemorrhage 〈Abstract〉 In X 3 years, a woman in her 70s was started on hemodialysis. Her PT and APTT were 11 and 24 sec, respectively, at that time. Nafamostat mesylate had been used during dialysis as of October X 1, after she developed gastric antral vascular ectasia. She was treated with antimicrobial agents for fever and cough in February X, but did not improve. She was consequently admitted to our facility. Aside from pneumonia, abnormal coagulation was observed (PT： 54 sec, APTT： 215 sec). Coagulation factor V activity was significantly reduced, and factor V inhibitor and antiFV autoantibodies were detected in the blood, indicating the presence of acquired factor V inhibitor. The patient showed a right temporal lobe hemorrhage on the 33rd day of hospitalization, and 10 units of platelet concentrate were transfused. On the 34th day, oral prednisolone at 20 mg/day was initiated. On the

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Haemodialysis Tunisian patient with acquired factor V inhibitor associated to arteriovenous shunt thrombosis

Abstract: Haemodialysis Tunisian patient with acquired factor V inhibitor associated to arteriovenous shunt thrombosisAnti-facteur V acquis et thrombose: à propos d'un cas et revue de la littérature

Cited by 3 publications

References 17 publications

Acquired factor V inhibitor with erythema and eosinophilia in a patient with end-stage renal disease

Acquired factor V inhibitor with erythema and eosinophilia in a patient with end-stage renal disease

Idiopathic factor V inhibitor in a patient starting haemodialysis

透析導入後に自己免疫性後天性凝固第ⅴ因子欠乏症を発症し，脳出血を呈した血液透析患者の1例

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