[Acquired factor V inhibitor: etiology, bleeding risk and therapeutic management with regard to three cases].
BACKGROUND
Acquired factor V inhibitor is rare and clinical symptoms are quite variable. Bleeding is the leading symptom but some patients are asymptomatic. Several diseases or conditions are associated with factor V inhibitors. Various treatments have been attempted but randomized or prospective trials are not available.


METHODS
Here we report three cases of acquired factor V inhibitor. These reports highlight the clinical variability of this disorder. Pathogenesis and therapy with reference to the literature are discussed.


CONCLUSIONS
Factor V inhibitors are rare and associated to several diseases or conditions. Pathogenesis is still unclear except in patients exposed to bovine thrombin. The majority of the cases developed after surgery. In a few cases there is an association to a malignant or autoimmune disease. Plasmapheresis and platelet transfusions might be the best treatment in case of severe bleeding. High-dose intravenous immunoglobulin infusions have been used successfully in some cases and we report here their efficacy in two cases.
Schleinitz
N
N
Service de médecine interne, hôpital de la Conception, 13385 Marseille, France. nschleinitz@mail.ap-hm.fr
Veit
V
V
Chouquet
D
D
Seux
V
V
Arnoux
D
D
Mokart
D
D
Lelong
B
B
Alessi
M C
MC
Kaplanski
G
G
Harlé
J R
JR
D000368:Aged; D001778:Blood Coagulation Disorders / Q000209:etiology*; D005165:Factor V / Q000037:antagonists & inhibitors*; D005260:Female; D006470:Hemorrhage / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012307:Risk Factors
D005165:Factor V