title: Acquired factor V inhibitor in a patient receiving venous-venous extracorporeal membrane oxygenation for Legionella pneumonia.
abstract: We report a rare complication of factor V deficiency in a patient having Legionella pneumonia. This patient also had other complications like severe acute respiratory distress syndrome, acute kidney injury, and septic shock that required venous-venous extracorporeal membrane oxygenation support. This is the first reported case of acquired factor V deficiency in a patient receiving extracorporeal membrane oxygenation for Legionella pneumonia. With the combined use of intravenous immunoglobulin, rituximab and plasma exchange, we achieved rapid clearance of the factor V inhibitor within 1 week so as to allow safe decannulation of extracorporeal membrane oxygenation.
authors.affiliation: Intensive Care Unit, Queen Elizabeth Hospital, Jordan, Hong Kong.
authors.forename: Anne K H
authors.initials: AK
authors.lastname: Leung
authors.affiliation: Intensive Care Unit, Queen Elizabeth Hospital, Jordan, Hong Kong.
authors.forename: George W Y
authors.initials: GW
authors.lastname: Ng
authors.affiliation: Intensive Care Unit, Queen Elizabeth Hospital, Jordan, Hong Kong.
authors.forename: K C
authors.initials: KC
authors.lastname: Sin
authors.affiliation: Intensive Care Unit, Queen Elizabeth Hospital, Jordan, Hong Kong.
authors.forename: S Y
authors.initials: SY
authors.lastname: Au
authors.affiliation: Intensive Care Unit, Queen Elizabeth Hospital, Jordan, Hong Kong.
authors.forename: K Y
authors.initials: KY
authors.lastname: Lai
authors.affiliation: Intensive Care Unit, United Christian Hospital, Kwun Tong, Hong Kong.
authors.forename: K L
authors.initials: KL
authors.lastname: Lee
authors.affiliation: Intensive Care Unit, United Christian Hospital, Kwun Tong, Hong Kong.
authors.forename: K I
authors.initials: KI
authors.lastname: Law
mesh_terms: D016638:Critical Illness / Q000628:therapy; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005166:Factor V Deficiency / Q000150:complications / Q000175:diagnosis*; D005500:Follow-Up Studies; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007262:Infusions, Intravenous; D007362:Intensive Care Units; D007875:Legionella / Q000302:isolation & purification*; D007877:Legionnaires' Disease / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000150:complications / Q000382:microbiology / Q000628:therapy; D035583:Rare Diseases; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D018570:Risk Assessment; D000069283:Rituximab / Q000627:therapeutic use; D012772:Shock, Septic / Q000150:complications / Q000382:microbiology / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D016756:Immunoglobulins, Intravenous; D000069283:Rituximab
keywords: Extracorporeal membrane oxygenation; Factor V; Legionella