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[Acquired factor V inhibitors in a polytraumatized patient]
Ljiljana Tukić1, Dragana Stamatović, Olivera Tarabar
1Vojnomedicinska akademija, Klinika za hematologiju, Beograd, Srbija i Crna Gora.
Vojnosanitetski Pregled
|September 21, 2005
Summary
Factor V (FV) inhibitors, a rare cause of bleeding, can spontaneously resolve. This case highlights a mild bleeding episode in a trauma patient that resolved within weeks as FV inhibitors disappeared naturally.
Area of Science:
- Hematology
- Immunology
Background:
- Factor V (FV) inhibitors are a rare condition, often idiopathic, typically presenting after surgery, infection, or antibiotic use.
- Clinical symptoms range from mild to severe, potentially life-threatening hemorrhage.
Observation:
- A 51-year-old male trauma patient presented with severe injuries and bleeding, exhibiting prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT).
- Despite initial treatment, coagulation tests remained abnormal, revealing significantly reduced Factor V activity (1%) due to inhibitors.
- The patient experienced a mild hemorrhagic syndrome, which resolved spontaneously over four weeks with normalization of coagulation parameters and antibody disappearance.
Findings:
- The patient developed Factor V inhibitors following polytrauma, presenting with a mild hemorrhagic syndrome.
- Substitution therapy was administered, and the inhibitors resolved spontaneously within four weeks.
- The spontaneous resolution supports observations that FV inhibitors may resolve faster in surgically treated patients.
Implications:
- This case underscores the importance of recognizing Factor V inhibitors in patients with unexplained bleeding, even after trauma.
- The spontaneous resolution observed suggests a favorable prognosis in some cases, potentially influenced by prior surgical interventions.
- Further research into the mechanisms and predictors of spontaneous Factor V inhibitor resolution is warranted.