title: Transient cefuroxime/metronidazole treatment induced factor V antibodies.
abstract: A 29-year-old patient presented with an appendicular infiltrate, initially treated with intravenous antibiotics, but later requiring percutaneous drainage. Both prothrombin time (PT) and activated partial thromboplastin time (aPTT) were prolonged on 3 days of antibiotic treatment and unresponsive to vitamin K or prothrombin complex concentrate. Laboratory investigation ultimately showed reduced factor V activity and factor V antibodies. In contrast to previously described cases of factor V antibodies, PT and aPTT were only mildly prolonged and residual factor V activity was still >20%. Draining of the abscess did not induce significant bleeding. Afterwards, no haemostatic medication was required. The patient was discharged from the hospital without complications. One week after cessation of the antibiotic treatment, PT and aPTT were within normal range again, with a factor V activity level of 36%. In conclusion, we present a patient with transient factor V antibodies, induced by antibiotics, without clinical bleeding tendency.
authors.affiliation: Laboratory for Clinical Chemistry and Hematology, Amphia Ziekenhuis, Breda, Noord Brabant, The Netherlands.
authors.forename: Sjoerd Adrianus Antonius
authors.initials: SA
authors.lastname: Van den Berg
authors.affiliation: Department of Internal Medicine, Amphia Ziekenhuis, Breda, Noord Brabant, The Netherlands.
authors.forename: Patricia E
authors.initials: PE
authors.lastname: Verwer
authors.affiliation: Laboratory for Clinical Chemistry and Hematology, Amphia Ziekenhuis, Breda, Noord Brabant, The Netherlands.
authors.forename: René N
authors.initials: RN
authors.lastname: Idema
authors.affiliation: Department of Internal Medicine, Amphia Ziekenhuis, Breda, Noord Brabant, The Netherlands.
authors.forename: Coen
authors.initials: C
authors.lastname: Van Guldener
mesh_terms: D018784:Abdominal Abscess / Q000188:drug therapy / Q000628:therapy; D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D000906:Antibodies / Q000097:blood*; D001778:Blood Coagulation Disorders / Q000209:etiology*; D002444:Cefuroxime / Q000009:adverse effects*; D004322:Drainage; D005165:Factor V / Q000276:immunology*; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000009:adverse effects*; D010314:Partial Thromboplastin Time; D011517:Prothrombin Time
chemical_list: D000900:Anti-Bacterial Agents; D000906:Antibodies; C035876:factor V clotting antigen; D008795:Metronidazole; D005165:Factor V; D002444:Cefuroxime