Acquired factor V inhibitor associated with life-threatening bleeding and a mixing test result that indicated coagulation factor deficiency

Masahiro Ashizawa, Shun ichi Kimura, Hidenori Wada, Miki Sato, Kiriko Terasako, Misato Kikuchi, Hideki Nakasone, Shinya Okuda, Shinichi Kako, Rie Yamazaki, Kumi Oshima, Katsuhiko Matsuura, Tsukasa Ohmori, Seiji Madoiwa, Junji Nishida, Jun Mimuro, Kaoru Tabei, Yoichi Sakata, Yoshinobu Kanda

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

A mixing test is useful for distinguishing between coagulation factor deficiency and the presence of inhibitor as the cause of coagulopathy. However, we experienced a patient with acquired factor V (FV) inhibitor whose mixing test showed a coagulation factor deficiency pattern. A 65-year-old man with a tendency for bleeding was referred to our center. The laboratory data showed remarkable prolongation of prothrombin time and activated partial thromboplastin time (APTT). FV activity was less than 3%. A mixing test showed a coagulation factor deficiency pattern. However, neither the tendency for bleeding nor the coagulation tests were corrected by transfusion of fresh frozen plasma. A few days later, a positive test for FV inhibitor of 3 Bethesda units was obtained. Therefore, we started prednisolone and plasma exchange, and the coagulation test results normalized after 6 weeks. Although an incubation period is generally not considered necessary in a mixing test for FV inhibitor, we repeated mixing tests with various incubation periods and confirmed an incubation period-dependent prolongation of the APTT. Therefore, a mixing test with an incubation period is recommended for the detection of FV inhibitor, since a mixing test without an incubation period may show a coagulation factor deficiency pattern when the titer of FV inhibitor is low.

Original languageEnglish
Pages (from-to)300-304
Number of pages5
JournalHematology
Volume18
Issue number5
DOIs
Publication statusPublished - 2013 Sep 1
Externally publishedYes

Fingerprint

Blood Coagulation Factors
Factor V
Hemorrhage
Partial Thromboplastin Time
Plasma Exchange
Prothrombin Time
Prednisolone

Keywords

  • Acquired factor V inhibitor
  • Coagulation factor deficiency
  • Mixing test

ASJC Scopus subject areas

  • Hematology

Cite this

Acquired factor V inhibitor associated with life-threatening bleeding and a mixing test result that indicated coagulation factor deficiency. / Ashizawa, Masahiro; Kimura, Shun ichi; Wada, Hidenori; Sato, Miki; Terasako, Kiriko; Kikuchi, Misato; Nakasone, Hideki; Okuda, Shinya; Kako, Shinichi; Yamazaki, Rie; Oshima, Kumi; Matsuura, Katsuhiko; Ohmori, Tsukasa; Madoiwa, Seiji; Nishida, Junji; Mimuro, Jun; Tabei, Kaoru; Sakata, Yoichi; Kanda, Yoshinobu.

In: Hematology, Vol. 18, No. 5, 01.09.2013, p. 300-304.

Research output: Contribution to journalArticle

Ashizawa, M, Kimura, SI, Wada, H, Sato, M, Terasako, K, Kikuchi, M, Nakasone, H, Okuda, S, Kako, S, Yamazaki, R, Oshima, K, Matsuura, K, Ohmori, T, Madoiwa, S, Nishida, J, Mimuro, J, Tabei, K, Sakata, Y & Kanda, Y 2013, 'Acquired factor V inhibitor associated with life-threatening bleeding and a mixing test result that indicated coagulation factor deficiency', Hematology, vol. 18, no. 5, pp. 300-304. https://doi.org/10.1179/1607845412Y.0000000072
Ashizawa, Masahiro ; Kimura, Shun ichi ; Wada, Hidenori ; Sato, Miki ; Terasako, Kiriko ; Kikuchi, Misato ; Nakasone, Hideki ; Okuda, Shinya ; Kako, Shinichi ; Yamazaki, Rie ; Oshima, Kumi ; Matsuura, Katsuhiko ; Ohmori, Tsukasa ; Madoiwa, Seiji ; Nishida, Junji ; Mimuro, Jun ; Tabei, Kaoru ; Sakata, Yoichi ; Kanda, Yoshinobu. / Acquired factor V inhibitor associated with life-threatening bleeding and a mixing test result that indicated coagulation factor deficiency. In: Hematology. 2013 ; Vol. 18, No. 5. pp. 300-304.
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