Severe hemorrhagic tendency due to factor V inhibitor in a hemodialysis patient: a case report.

Ishizu, Masanao; Kuroiwa, Mika; Tanaka, Kenji; Hasegawa, Yoshiyuki

doi:10.4009/jsdt.36.1285

Cited by 4 publications

(2 citation statements)

References 7 publications

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“…Although there have been two reported cases of AFVIs occurring in patients on maintenance hemodialysis ( 7 , 17 ), this is the first case of AFVIs in a patient initiating hemodialysis for end-stage renal disease.…”

Section: Discussionmentioning

confidence: 86%

Acquired Factor V Inhibitors in a Patient with End-stage Renal Disease

et al. 2016

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We report a case of acquired factor V inhibitors (AFVIs) in a patient with end-stage renal disease receiving warfarin therapy for atrial fibrillation. A 72-year-old Japanese man was admitted to our hospital complaining of tarry stools and abdominal pain. The laboratory findings revealed eosinophilia (52.1%), prolonged activated partial thromboplastin time (APTT) (98 s), PT (84 s), a factor V (FV) activity of <3%, and an FV inhibitor level of 6 Bethesda units/mL. After administration of prednisolone was started, his coagulation findings improved. However, his renal failure progressed, and he ultimately required chronic hemodialysis. This is the first case of AFVIs in a patient starting hemodialysis for end-stage renal disease.

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Section: Discussionmentioning

confidence: 86%

Acquired Factor V Inhibitors in a Patient with End-stage Renal Disease

et al. 2016

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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 above-mentioned patients, hemostatic defect in arteriovenous fistula may be related to antimicrobial therapy (Table 4 ) [ 3 , 9 – 16 ]. Furthermore, AiFVD and eosinophilia were reported in four other patients with renal disease beside our patient [ 12 , 17 – 19 ].…”

Section: Discussionmentioning

confidence: 99%

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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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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Severe hemorrhagic tendency due to factor V inhibitor in a hemodialysis patient: a case report.

Cited by 4 publications

References 7 publications

Acquired Factor V Inhibitors in a Patient with End-stage Renal Disease

Acquired Factor V Inhibitors 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

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