Advertisement

Annals of Hematology

, Volume 97, Issue 10, pp 2009–2010 | Cite as

A rare case of an acquired factor V inhibitor in a patient with myelodysplastic syndrome during azacitidine treatment

  • Yuriko Fujita
  • Tomonori Nakazato
  • Chisako Ito
  • Kyoko Masuda
  • Yuki Osada
  • Yoshinobu Aisa
  • Takehiko Mori
Letter to the Editor

Dear Editor,

An 82-year-old man presented to the emergency department (ED) with a 1-day history of gum bleeding. He had been diagnosed with myelodysplastic syndrome (MDS) and refractory anemia with excess blasts (RAEB-1) with trisomy 21 1 year earlier. Azacitidine (75 mg/m 2/day over 7 days) had been started 1 month before his bleeding episode. At his arrival at the ED, his complete blood count showed a white blood cell (WBC) of 7900/μL, hemoglobin of 67 g/L, and platelet count of 5 × 10 9/L. He also had a prolonged activated partial thromboplastin time (APTT) (295.3 s) and prothrombin time (PT) (16%) (Table 1). His fibrinogen was slightly elevated (476 mg/dL), and his ATIII, FDP, and D-dimer values were within normal limits. On an examination, he showed bleeding from the oral mucosa and gums and ecchymosis on his extremities.
Table 1

Changes in coagulation parameters after steroid administration

 

Before treatment

After steroid administration

PT (%)

16

63

APTT (s)

295.3

34.2

Factor V...

Keywords

Factor V inhibitor Myelodysplastic syndrome Azacitidine 

Notes

Compliance with ethical standards

Informed consent

Written informed consent was obtained from the patient for publication.

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Franchini M, Lippi G (2011) Acquired factor V inhibitors: a systematic review. J Thromb Thrombolysis 31:449–457CrossRefGoogle Scholar
  2. 2.
    Knobl P, Lechner K (1998) Acquired factor V inhibitors. Baillieres Clin Haematol 11:305–318CrossRefGoogle Scholar
  3. 3.
    Giannouli S, Voulgarelis M, Zintzaras E, Tzioufas AG, Moutsopoulos HM (2004) Autoimmune phenomena in myelodysplastic syndromes: a 4-yr prospective study. Rheumatology (Oxford) 43:626–632CrossRefGoogle Scholar
  4. 4.
    Milojkovic D, Patel R, Ford E, Arya R, Mufti G (2007) Acquired factor V inhibitor after haematopoietic stem cell transplantation. Thromb Haemost 98:685–687CrossRefGoogle Scholar
  5. 5.
    Chediak J, Ashenhurst JB, Garlick I, Desser RK (1980) Successful management of bleeding in a patient with factor V inhibitor by platelet transfusions. Blood 56:835–841Google Scholar
  6. 6.
    Tracy PB, Eide LL, Bowie EJ, Mann KG (1982) Radioimmunoassay of factor V in human plasma and platelets. Blood 60:59–63Google Scholar
  7. 7.
    Ang AL, Kuperan P, Ng CH, Ng HJ (2009) Acquired factor V inhibitor. A problem-based systemic review. Thromb Haematol 101:852–859Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Yuriko Fujita
    • 1
  • Tomonori Nakazato
    • 1
  • Chisako Ito
    • 1
  • Kyoko Masuda
    • 1
  • Yuki Osada
    • 1
  • Yoshinobu Aisa
    • 1
  • Takehiko Mori
    • 2
  1. 1.Department of HematologyYokohama Municipal Citizen’s HospitalYokohamaJapan
  2. 2.Division of HematologyKeio University School of MedicineTokyoJapan

Personalised recommendations