Rare Case Report: Acquired Factor V Deficiency With an Idiopathic Inhibitor

Abstract

Acquired factor V deficiency is a rare disorder caused by inhibitor formation of idiopathic origin, bovine protein exposure, antibiotics, infection, malignancy, autoimmune disease, transfusion, or pregnancy. The disorder has variable clinical manifestations. The optimal treatment modality of acquired factor V deficiency is not fully determined. The use of plasmapheresis, a suggested treatment, is seldom reported. We herein describe the case of an 83-year-old woman with incident impression of acquired factor V deficiency with an idiopathic inhibitor. Her coagulopathy responded poorly to fresh frozen plasma, single-donor platelets, and steroids. Active gastrointestinal bleeding was noted and supposed by acquired factor V deficiency during admission. Plasmapheresis resolved her active bleeding and coagulopathy. Clinicians should consider plasmapheresis when treating acute haemorrhagic events in patients with acquired factor V deficiency. Further investigation is required to establish the optimal dose and treatment course of plasmapheresis.