Occurrence of acquired factor V inhibitor during antibiotic therapy for a surgical wound infection

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  • OKABE Takashi
    Division of Hematology, Department of Internal Medicine, National Hospital Organization Tokyo Medical Center
  • UENO Hironori
    Division of Hematology, Department of Internal Medicine, National Hospital Organization Tokyo Medical Center
  • FUJITA Shinya
    Division of Hematology, Department of Internal Medicine, National Hospital Organization Tokyo Medical Center
  • KAGOO Toshiya
    Division of Hematology, Department of Internal Medicine, National Hospital Organization Tokyo Medical Center
  • BOKU Saigen
    Division of Hematology, Department of Internal Medicine, National Hospital Organization Tokyo Medical Center
  • YANO Takahiro
    Division of Hematology, Department of Internal Medicine, National Hospital Organization Tokyo Medical Center
  • YOKOYAMA Akihiro
    Division of Hematology, Department of Internal Medicine, National Hospital Organization Tokyo Medical Center

Bibliographic Information

Other Title
  • 術後創部感染に対する抗菌薬投与中に出現した後天性第V因子インヒビター
  • 症例報告 第7回日本血液学会関東甲信越地方会 優秀演題 術後創部感染に対する抗菌薬投与中に出現した後天性第Ⅴ因子インヒビター
  • ショウレイ ホウコク ダイ7カイ ニホン ケツエキ ガッカイ カントウ コウシンエツチホウカイ ユウシュウ エンダイ ジュツゴソウブ カンセン ニ タイスル コウキンヤク トウヨ チュウ ニ シュツゲン シタ コウテンセイ ダイ Ⅴ インシ インヒビター

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Abstract

<p>Acquired factor V (FV) inhibitor is a rare disorder. Herein we report a case of an 82-year-old Japanese woman with FV inhibitor exhibiting a pseudo decline in the activities of the multiple coagulation factors. After rectal cancer surgery, she received antibiotic therapy for wound infection. As prothrombin and activated partial thromboplastin time was prolonged, heparin for atrial fibrillation was discontinued without improvement. Coagulation factor activity assays revealed deficiencies in II, V, VII, VIII, IX, X, XI, and XII factor activities; in particular, the FV activity was markedly decreased to <1%. The cross-mixing test findings revealed an inhibitor pattern, and multiple coagulation factor inhibitors were positive. The FV inhibitor level was high at 62 Bethesda U/ml. The patient exhibited no bleeding tendency with the prolonged wound infection without immunosuppressive therapy. The inhibitor disappeared four months after the onset.</p>

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 59 (8), 1007-1011, 2018

    The Japanese Society of Hematology

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