Wang Xiangyu, Qin Xuemei, Yu Yuan, Wang Ran, Liu Xinguang, Ji Min, Zhou Minran, Chen Chunyan
Department of Hematology, Qilu Hospital, Shandong University, Jinan, Shandong, P. R. China.
Blood Coagul Fibrinolysis. 2017 Jun;28(4):334-341. doi: 10.1097/MBC.0000000000000581.
: 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.
获得性因子V缺乏症(AFVD)是一种罕见的止血障碍,主要是由于因子V抑制剂的产生。大约已报告了200例病例,其中大部分病例是由于接触牛凝血酶所致。我们报告一例男性患者,该患者先出现血尿,随后出现多处出血,同时凝血酶原时间和活化部分凝血活酶时间升高。检查发现因子V活性降低,因子V抑制剂水平为1.9 BU,这可能继发于尿路感染。使用皮质类固醇,我们成功消除了抑制剂并控制了出血。我们回顾已发表的文献以确定与非牛凝血酶AFVD相关的情况。我们认为,对于出现多处出血的患者应考虑到AFVD。