Premium
Hemorrhagic death associated with a high titer factor V inhibitor
Author(s) -
Coots Macie C.,
Muhleman Albert F.,
Glueck Helen I.
Publication year - 1978
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.2830040212
Subject(s) - medicine , hyperfibrinolysis , bleeding diathesis , antifibrinolytic , clotting factor , gastroenterology , coagulopathy , exploratory laparotomy , immunology , titer , antibody , surgery , platelet , tranexamic acid , blood loss
An acquired bleeding diathesis was first noted in a 51‐year‐old patient 11 days following an exploratory laparotomy. Laboratory studies indicated the cause of bleeding to be the development of a circulating anticoagulant which inhibited factor V activity. The inhibitor, an immunoglobulin of the IgG class, was separated by use of Sephadex G‐200 filtration, disc electrophoresis, and isoelectric focusing. Despite vigorous immunosuppressive, antifibrinolytic, and replacement therapy, including the use of a “prothrombin complex” and plasmaphoresis, the bleeding diathesis could not be reversed and the patient died of hemorrhage. Although inhibitors to factor V are not usually associated with major life‐threatening hemorrhage, this case demonstrates that the development of such an inhibitor can be an ominous finding. The use of an aminoglycoside antibiotic in this and other patients so reported may be one of the contributing causes to the development of such an inhibitor.