A Case of Acquired Factor V Deficiency in a Hemodialysis Patient: A Case Report With Literature Review

Acquired factor V (FV) deficiency is a rare bleeding disorder requiring careful management, especially in hemodialysis (HD) patients who regularly receive anticoagulants. We present a case of recurrent acquired FV deficiency in a dialysis patient.

A 76-year-old man on HD with a history of acquired FV deficiency developed third-degree burns and persistent bleeding. Lab tests confirmed the recurrence of the deficiency. Initial treatments with rituximab and cyclophosphamide were ineffective. When prednisolone was rechallenged, the activity of coagulation FV was rapidly improved, and coagulation function was confirmed to have returned to normal. HD was managed without anticoagulants during critical periods. No major bleeding events were observed during HD.

This case underscores the complexities of managing acquired FV deficiency in patients on HD. It highlights the importance of individualized anticoagulation strategies and close monitoring of coagulation profiles to prevent bleeding complications and ensure the safety of HD.