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Related Experiment Videos

A factor V inhibitor: in vitro interference by calcium.

M C Coots, A F Muhleman, H I Glueck

    American Journal of Hematology
    |January 1, 1979
    PubMed
    Summary
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    A rare factor V inhibitor resistant to therapy was studied. Adding calcium diminished its activity, suggesting calcium infusion may help manage this inhibitor, especially during metabolic acidosis.

    Area of Science:

    • Hematology
    • Immunology
    • Biochemistry

    Background:

    • A patient presented with a factor V inhibitor resistant to standard therapies.
    • Factor V inhibitors can cause serious bleeding complications.
    • Understanding inhibitor mechanisms is crucial for effective treatment.

    Purpose of the Study:

    • To investigate the characteristics of a therapy-resistant factor V inhibitor.
    • To explore factors influencing the inhibitor's activity in vitro.
    • To identify potential therapeutic strategies for managing this inhibitor.

    Main Methods:

    • In vitro assays including prothrombin time, partial thromboplastin time, and Russell's viper venom time were employed.
    • The effects of calcium chloride and calcium gluconate on inhibitor activity were assessed.

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  • Isofocused fraction, plasma, and serum were used to analyze the inhibitor's properties.

    • Main Results:

    • The inhibitor's activity was significantly reduced by the addition of calcium chloride or calcium gluconate.
    • The inhibitor is an IgG4 (lambda) immunoglobulin with high calcium binding affinity.
    • Inhibitor activity was markedly potentiated under acidic pH conditions.

    Conclusions:

    • Calcium may play a critical role in the function of this factor V inhibitor.
    • In vivo calcium infusion could be a potential therapeutic approach.
    • Metabolic acidosis, common in hemorrhagic shock, may potentiate this inhibitor, highlighting the need for careful management.