Acquired factor V inhibitor treated with rituximab

Area of Science:

• Hematology
• Immunology

Background:

• Acquired factor V (FV) inhibitors are rare autoimmune disorders.
• Diagnosis is challenging due to varied clinical presentations and lack of standard treatment.

Observation:

• A male patient in his 50s presented with bleeding symptoms including epistaxis and oozing.
• Laboratory tests revealed significantly low FV activity (<1%) and high FV inhibitor titer (184 BU/mL).

Findings:

• Initial treatment with fresh frozen plasma, platelets, tranexamic acid, IV immunoglobulin, and glucocorticoids provided only minimal improvement.
• Subsequent treatment with weekly rituximab for 4 weeks, combined with glucocorticoids, was well-tolerated and effective.

Implications:

• This case highlights rituximab as a potential therapeutic option for acquired FV inhibitors.
• Further research is warranted to establish rituximab's role in managing this rare bleeding disorder.