Successful Outcome of Severe Intra-cerebral Bleeding Associated with Acquired Factor V Inhibition: Utilization of Multiple Therapeutic Agents

Yıl 2018, Cilt: 35 Sayı: 1, 112 - 115, 01.01.2018

Panagiotis Andreadis Katerina Kafantari Aleka Agapidou Sofia Vakalopoulou Efthymia Vlachaki

Öz

-Background: Acquired coagulation factor inhibitors
are antibodies that either inhibit activity or increase the
clearance of a clotting factor and lead to an increased
risk of bleeding. Most of the time, the disorder is
attributed to factor VIII inhibition (acquired haemophilia
A); however, other coagulation factors could also be
implicated.
Case Report: Herein, we report an interesting case
of a patient who underwent coronary artery bypass
grafting and received antibiotic treatment after surgery
with third generation cephalosporin. A month later,
he presented with extreme bleeding diathesis and
cerebral haemorrhage. Following a thorough clinical
and laboratory investigation, an acquired factor V
inhibitor was diagnosed. The patient received treatment
with corticosteroids, intravenous immunoglobulins,
anti-CD20 monoclonal antibodies (rituximab),
cyclophosphamide and recombinant factor VIIa. Finally,
despite the poor initial prognosis, the patient managed to
achieve a full recovery.
Conclusion: As there are no clear guidelines on acquired
coagulation inhibitor treatment, reports of such cases
could offer insight for future therapy choices. The case
was unique because the treatment regimen included a
combination

Anahtar Kelimeler

Haemophilia, factor V, rituximab, inhibitor, cephalosporin

Kaynakça

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