International Journal of Hematology

, Volume 108, Issue 2, pp 145–150 | Cite as

A discrepancy between prothrombin time and Normotest (Hepaplastintest) results is useful for diagnosis of acquired factor V inhibitors

  • Yasuko KadohiraEmail author
  • Shinya Yamada
  • Tomoe Hayashi
  • Eriko Morishita
  • Hidesaku Asakura
  • Akitada Ichinose
Original Article


Acquired coagulation factor inhibitors are rare. Among them, coagulation factor V (FV) inhibitor is particularly uncommon and presents with variable clinical manifestations. Certain acquired FV inhibitor patients have only mild bleeding or, in select cases, no symptoms at all, leading to spontaneous recovery. Others have life-threatening bleeding that requires medical attention. Thus, a prompt decision regarding diagnosis and clinical intervention is crucial for such patients. In five acquired FV inhibitor cases treated in our facility, each patient had a malignancy as an underlying disease and all unexpectedly showed prolongation of both prothrombin time (PT) and activated partial thromboplastin time (APTT). They all also displayed a discrepancy between PT and Normotest (Hepaplastintest, HPT) results. All but one patient experienced no bleeding at the time of diagnosis and achieved spontaneous recovery in 1–3 weeks. The patient with bleeding symptoms received plasma exchanges and a platelet transfusion. Useful markers in diagnosing the presence of an acquired FV inhibitor were a sudden prolongation of PT and APTT, and a discrepancy between the PT/APTT and HPT assays. Spontaneous recovery can be expected for patients with only minor bleeding.


Acquired factor V inhibitors Normotest (Hepaplastintest) Cross-mixing test Diagnosis 



This study was supported in part by research aids from the Japanese Ministry of Health, Labor, and Welfare (to A.I.). We would like to thank all members of the “Japanese Collaborative Research Group (JCRG) on Autoimmune Haemorrhaphilia”.

Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest in association with the present study.


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Copyright information

© The Japanese Society of Hematology 2018

Authors and Affiliations

  • Yasuko Kadohira
    • 1
    Email author
  • Shinya Yamada
    • 1
  • Tomoe Hayashi
    • 1
  • Eriko Morishita
    • 1
  • Hidesaku Asakura
    • 1
    • 2
  • Akitada Ichinose
    • 2
    • 3
  1. 1.Department of HematologyKanazawa University HospitalKanazawaJapan
  2. 2.Japanese Collaborative Research Group on Autoimmune Haemorrhaphilia Supported by the Japanese Ministry of Health, Labor and WelfareYamagataJapan
  3. 3.Department of Molecular Patho-Biochemistry and Patho-BiologyYamagata University SchoolYamagataJapan

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