Acquired factor V inhibitor after exposure to topical human thrombin related to an otorhinolaryngological procedure.
Acquired factor V (FV) inhibitors occur rarely and classically develop after exposure to bovine thrombin. The clinical presentation is variable, ranging from asymptomatic with incidental laboratory abnormalities to significant bleeding. With the development of human-derived thrombin agents, bovine thrombin is less frequently used. We report a case of an acquired FV inhibitor that developed in a patient after exposure to human thrombin used as a hemostatic agent during an otorhinolaryngology surgical procedure. Our review of the literature revealed only one prior reported case of FV inhibitor after exposure to human thrombin. Hematologists and surgeons should be aware of this rare, but potentially life-threatening, complication in the postprocedural setting.
Hematology and Oncology, Lenox Hill Hospital, New York, NY, USA.
K
K
Donohoe
Hematology and Oncology, Lenox Hill Hospital, New York, NY, USA.|Blood Bank, Lenox Hill Hospital, New York, NY, USA.
R
R
Levine
D000287:Administration, Topical; D000368:Aged; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D005165:Factor V / Q000276:immunology* / Q000378:metabolism; D005166:Factor V Deficiency / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis / Q000276:immunology; D005260:Female; D006490:Hemostatics / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D013917:Thrombin / Q000008:administration & dosage / Q000009:adverse effects*; D013997:Time Factors
D001323:Autoantibodies; D015415:Biomarkers; D006490:Hemostatics; D005165:Factor V; D013917:Thrombin
autoantibodies; bleeding; factor V; hemorrhage; recombinant human thrombin