Park Young Hoon, Lim Joo Han, Yi Hyeon Gyu, Lee Moon Hee, Kim Chul Soo
Department of Hematology-Oncology, Inha University Hospital and School of Medicine, Incheon, Korea.
J Korean Med Sci. 2016 Feb;31(2):208-13. doi: 10.3346/jkms.2016.31.2.208. Epub 2016 Jan 25.
Due to rarity of factor V (FV) deficiency, there have been only a few case reports in Korea. We retrospectively analysed the clinical-laboratory features of FV deficiency in 10 Korean patients. Between January 1987 and December 2013, 10 case reports published in a Korean journal or proceedings of Korea Society on Thrombosis and Hemostasis were reviewed. Severity is defined as mild (> 5% of factor activity), moderate (1%-5%), and severe (< 1%). The median age at diagnosis, six males and four females, was 26 years (range, 1 month-73 years). Six of 10 patients were classified as moderate, three as mild, and one as severe disease. Eight patients were diagnosed as inherited FV deficiency. The most frequent symptoms were mucosal tract bleedings (40%) such as epistaxis, and menorrhagia in female. Hemarthroses and postoperative bleeding occurred in one and four patients, respectively. Life-threatening bleeding episodes occurred in the peritoneal cavity (n = 2), central nerve system (n = 1), and retroperitoneal space (n = 1). No lethal haemorrhages happened to patients with mild disease. The majority of bleeding episodes were controlled with local measures and fresh-frozen plasma replacement. Two acquired FV deficient-patients showing life-threatening haemorrhages received the immunosuppressive therapy, but one of them died from postoperative bleeding complications. Despite the small sample size of this study due to rarity of the disease, we found that Korean patients with FV deficiency had similar clinical manifestations and treatment outcomes shown in previous studies.
由于因子V(FV)缺乏症较为罕见,韩国仅有少数病例报告。我们回顾性分析了10例韩国患者FV缺乏症的临床实验室特征。1987年1月至2013年12月期间,对韩国一本期刊或韩国血栓与止血学会会议记录中发表的10例病例报告进行了回顾。严重程度定义为轻度(因子活性>5%)、中度(1%-5%)和重度(<1%)。诊断时的中位年龄为26岁(范围为1个月至73岁),其中6例男性,4例女性。10例患者中有6例被归类为中度疾病,3例为轻度,1例为重度。8例患者被诊断为遗传性FV缺乏症。最常见的症状是黏膜出血(40%),如鼻出血,女性患者有月经过多。分别有1例和4例患者发生关节积血和术后出血。危及生命的出血事件发生在腹腔(n = 2)、中枢神经系统(n = 1)和腹膜后间隙(n = 1)。轻度疾病患者未发生致命性出血。大多数出血事件通过局部措施和新鲜冷冻血浆置换得到控制。2例获得性FV缺乏症患者出现危及生命的出血,接受了免疫抑制治疗,但其中1例死于术后出血并发症。尽管由于该疾病罕见,本研究样本量较小,但我们发现韩国FV缺乏症患者的临床表现和治疗结果与先前研究相似。