Acquired Factor V Inhibitor Complicated with Immune Thrombocytopenia

• Published in: Internal Medicine Vol. 61; no. 1; pp. 91 - 95
• Main Authors: Mima, Fuka, Minami, Ryota, Asako, Mizuki, Matsunaga, Hitomi, Fujita, Yuri, Takimoto, Yoshimi, Senda, Sonoko, Nakahara, Wataru, Ikeda, Mako, Ueda, Shuji
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.01.2022; Japan Science and Technology Agency
• Subjects: acquired factor V inhibitor; Bleeding; Blood Platelets; Case Report; Coagulation factors; Factor V; fatal hemorrhaging; Humans; Idiopathic thrombocytopenic purpura; immune thrombocytopenia; Immunosuppressive agents; Internal medicine; Platelet Count; platelet-derived factor V; Platelets; Prednisolone; Purpura, Thrombocytopenic, Idiopathic - complications; Purpura, Thrombocytopenic, Idiopathic - diagnosis; Purpura, Thrombocytopenic, Idiopathic - drug therapy; Thrombocytopenia; Thrombocytopenia - chemically induced; fatal hemorrhaging; acquired factor V inhibitor; immune thrombocytopenia; platelet-derived factor V
• ISSN: 0918-2918; 1349-7235; 1349-7235
• DOI: 10.2169/internalmedicine.7173-21

We herein report a patient with a high bleeding tendency as a result of acquired factor V inhibitor and immune thrombocytopenia (ITP). The administration of prednisolone increased the platelet count, but a fatal bleeding event occurred before platelet levels had sufficiently increased. Factor V is stored in not only plasma but also platelets, and platelet-derived factor V might play a local hemostatic role. Bleeding tendency may be high in rare cases where factor V inhibitor is complicated with severe thrombocytopenia. In such patients, physicians should consider aggressive hemostatic therapy, including plasma exchange, in addition to immunosuppressive therapy.