Fatal hemorrhage due to a spontaneous factor V inhibitor with lupus anticoagulant properties
| Autor: | Amin A. Hedayat, Nicholas J. Olson, Donna Robert, Deborah L. Ornstein, Xiaoying Liu |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
030204 cardiovascular system & hematology Thrombin time Bethesda unit Gastroenterology 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Blood Coagulation Aged Prothrombin time Lupus anticoagulant medicine.diagnostic_test biology business.industry Factor V Pneumonia Hematology General Medicine Mixing study medicine.disease Anti-Bacterial Agents Surgery Hematoma Subdural Coagulation Lupus Coagulation Inhibitor 030220 oncology & carcinogenesis biology.protein Female Blood Coagulation Tests business Intracranial Hemorrhages Partial thromboplastin time |
| Zdroj: | Blood Coagulation & Fibrinolysis. 28:407-410 |
| ISSN: | 0957-5235 |
| Popis: | UNASSIGNED Factor V inhibitors are rare and have varied clinical presentations. We report on a 76-year-old female admitted to the hospital for pneumonia and treated with multiple antibiotics. Her baseline prothrombin time was 15.6 s and the activated partial thromboplastin time was 35 s. On admission day 10, she developed arm weakness and brain imaging showed a subdural hematoma. The prothrombin time was now 59.1 s with an activated partial thromboplastin time of more than 160 s and a normal thrombin time. A mixing study did not correct the clotting times and coagulation factor assays showed a nonspecific inhibition pattern. Only factor V activity remained low with serial dilutions, however, and a 70 Bethesda Unit inhibitor was identified. Aggressive supportive care was initiated but the patient succumbed to the effects of the intracranial hemorrhage. Factor V inhibitors may display lupus anticoagulant properties and may cause catastrophic bleeding. Our case illustrates that these inhibitors can arise quickly and supports an association with antibiotics. |
| Databáze: | OpenAIRE |
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