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Updated: Jun 23, 2026
13:08
Measurement of Factor V Activity in Human Plasma Using a Microplate Coagulation Assay
Published on: September 9, 2012
Acquired factor V inhibitor. A problem-based systematic review
Ai Leen Ang1, Ponnudurai Kuperan, Chin Hin Ng
1Department of Haematology, Singapore General Hospital, Outram Road, Singapore 169608. ang.ai.leen@sgh.com.sg
Thrombosis and Haemostasis
|May 1, 2009
Summary
Acquired Factor V inhibitors are rare bleeding disorders. This review suggests platelet transfusions may be first-line therapy, and inhibitor elimination therapy is recommended for bleeding patients.
Area of Science:
- Hematology
- Rare Diseases
Background:
- Acquired Factor V (FV) inhibitors represent a rare bleeding disorder.
- Limited evidence exists for managing this condition.
Purpose of the Study:
- To review acquired FV inhibitor cases in Singapore and the literature.
- To answer clinical questions on manifestation and management of non-bovine thrombin and non-congenital acquired FV inhibitors.
Main Methods:
- Systematic review of Singaporean cases and published literature.
- Inclusion criteria focused on non-bovine thrombin and non-congenital acquired FV inhibitors.
Main Results:
- Incidence in Singapore: 0.09 cases/million person-years.
- Bleeding occurred in 68.4% of patients; mucous membrane bleeds were most common.
- Intracranial and retroperitoneal bleeds had highest mortality (12% overall bleeding mortality).
- FV levels and PT/aPTT prolongation tended to predict bleeding.
- Platelet transfusion suggested as first-line therapy.
- Inhibitor elimination therapy (IET) accelerated inhibitor disappearance in bleeding patients (60 vs. 150 days).
- Steroids were effective as single-agent IET in most cases.
Conclusions:
- Management approaches are limited by small sample sizes and heterogeneity.
- A comprehensive registry is needed for more reliable data.
- IET is recommended for bleeding patients or those at high risk.
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