title: Acquired factor V deficiency in a patient with a urinary tract infection presenting with haematuria followed by multiple haemorrhages with an extremely low level of factor V inhibitor: a case report and review of the literature.
abstract: : Acquired factor V deficiency (AFVD) is a rare haemostatic disorder that is primarily because of the development of factor V inhibitors. Approximately, 200 cases have been reported and the greatest portion of these cases was because of bovine thrombin exposure. We report a case of a man who presented with haematuria followed by multiple haemorrhages associated with an elevated prothrombin time and an activated partial thromboplastin time. A workup revealed reduced factor V activity and a factor V inhibitor level of 1.9 BU, which were likely secondary to a urinary tract infection. Using corticosteroids, we successfully eliminated the inhibitor and controlled the bleeding. We review the published literature to identify the conditions that are associated with nonbovine thrombin AFVD. We assume that AFVD should be kept in mind for patients who present with multiple haemorrhages.
authors.affiliation: Department of Hematology, Qilu Hospital, Shandong University, Jinan, Shandong, P. R. China.
authors.forename: Xiangyu
authors.initials: X
authors.lastname: Wang
authors.forename: Xuemei
authors.initials: X
authors.lastname: Qin
authors.forename: Yuan
authors.initials: Y
authors.lastname: Yu
authors.forename: Ran
authors.initials: R
authors.lastname: Wang
authors.forename: Xinguang
authors.initials: X
authors.lastname: Liu
authors.forename: Min
authors.initials: M
authors.lastname: Ji
authors.forename: Minran
authors.initials: M
authors.lastname: Zhou
authors.forename: Chunyan
authors.initials: C
authors.lastname: Chen
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000818:Animals; D001323:Autoantibodies / Q000097:blood; D001780:Blood Coagulation Tests; D002417:Cattle; D003937:Diagnosis, Differential; D005165:Factor V / Q000037:antagonists & inhibitors / Q000276:immunology*; D005166:Factor V Deficiency / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D006417:Hematuria; D006470:Hemorrhage / Q000188:drug therapy; D006474:Hemorrhagic Disorders; D006801:Humans; D008297:Male; D008875:Middle Aged; D013917:Thrombin; D014552:Urinary Tract Infections / Q000150:complications / Q000473:pathology*
chemical_list: D000305:Adrenal Cortex Hormones; D001323:Autoantibodies; D005165:Factor V; D013917:Thrombin