Related Experiment Video
Updated: Jun 7, 2026
Measurement of Factor V Activity in Human Plasma Using a Microplate Coagulation Assay
Published on: September 9, 2012
Development of antibodies to human thrombin and factor V in a pediatric patient exposed to topical bovine thrombin
Clara Y Lo1, Carol Jones, Bertil Glader
1Department of Pediatric, Stanford University, Stanford, California, USA.
Insights
Bovine thrombin used in pediatric surgery can rarely cause acquired inhibitors to factor V and thrombin. This case highlights a child who developed bleeding and inhibitors after bovine thrombin exposure.
Area of Science:
- Coagulation science
- Pediatric surgery
- Immunology
Background:
- Bovine topical thrombin is a common hemostatic agent in pediatric surgery.
- Acquired inhibitors to coagulation factors, especially factor V and bovine thrombin, are rare in children.
Observation:
- A 3-year-old male experienced coagulopathy and bleeding post-cardiothoracic surgery.
- Bovine topical thrombin was utilized for local hemostasis during the procedure.
Findings:
- Laboratory results showed prolonged clotting times and low factor V activity.
- The patient developed inhibitors to both human thrombin and factor V.
- This represents one of the first reported instances of combined inhibitors secondary to bovine thrombin exposure.
Implications:
- This case underscores the potential for rare but serious immune responses to bovine thrombin in pediatric patients.
- Prompt diagnosis and treatment with immunosuppressants like IVIG and steroids can lead to favorable outcomes.
- Highlights the importance of considering acquired inhibitors in pediatric bleeding post-surgery.
Abstract:
Bovine topical thrombin is commonly used for local hemostasis in pediatric surgery. Acquired inhibitors to coagulation factors, particularly to factor V and bovine thrombin, have been infrequently reported in the pediatric population. We report a 3-year-old male who developed a coagulopathy and clinical bleeding after cardiothoracic surgery, during which bovine topical thrombin was used for local hemostasis. Laboratory tests revealed elevated prothrombin, partial thromboplastin, and thrombin times, and a low factor V activity level. He was found to have both human-thrombin and factor V inhibitors, among the first reported cases of these combined inhibitors secondary to bovine topical thrombin. He was treated with intravenous immunoglobulin and steroids with a rapid and durable response.
Related Concept Videos
01:22Development of Immunocompetence
The initial cells that migrate from the fetal thymus settle within the skin and epithelial tissues lining the mouth, digestive tract, and in females, the uterus and vagina. These cells, including skin-based dendritic cells, serve as antigen-presenting cells, playing a key role in T cell activation.
Subsequent T...
01:29Venous Thrombosis III: Interprofessional Care