Imataki Osamu, Arai Takeshi, Uemura Makiko
Division of Hematology and Stem Cell Transplantation, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Japan.
Department of Laboratory Medicine, Kagawa University Hospital, Japan.
Intern Med. 2017;56(10):1203-1206. doi: 10.2169/internalmedicine.56.7845. Epub 2017 May 15.
An acquired formation of inhibitors to coagulation factors is a rare type of coagulopathy. The development of inhibitors for multiple coagulation factors has never been reported. A 75-year-old Japanese female underwent interventional therapy for hepatocellular carcinoma. Five days after the last intervention, her prothrombin time decreased to 10%, and her activated partial thromboplastin time (APTT) lengthened to 265.1 sec. The activities for coagulation factors showed significantly reduced activities (<10%) of factors V, IX, and XII. A cross-mixing test demonstrated an inhibitor pattern, and inhibitory antibodies against factors V, IX, and XII were detected. We discuss our patient's etiology and pathogenesis.
获得性凝血因子抑制剂形成是一种罕见的凝血病类型。多种凝血因子抑制剂的出现从未有过报道。一名75岁的日本女性接受了肝细胞癌的介入治疗。最后一次介入治疗五天后，她的凝血酶原时间降至10%，活化部分凝血活酶时间（APTT）延长至265.1秒。凝血因子活性显示因子V、IX和XII的活性显著降低（<10%）。交叉混合试验显示出抑制剂模式，并检测到针对因子V、IX和XII的抑制性抗体。我们讨论了该患者的病因和发病机制。
