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Acquired factor V inhibitor in the setting of coronavirus disease 2019 infection.
Bennett, Joseph; Cunningham, Mark T; Howard, Christin; Hoffmann, Marc; Plapp, Fred V.
  • Bennett J; Department of Internal Medicine.
  • Cunningham MT; Department of Pathology and Laboratory Medicine.
  • Howard C; Department of Hematologic Malignancies and Cellular Therapeutics, University of Kansas Medical Center, Kansas City, Kansas, USA.
  • Hoffmann M; Department of Hematologic Malignancies and Cellular Therapeutics, University of Kansas Medical Center, Kansas City, Kansas, USA.
  • Plapp FV; Department of Pathology and Laboratory Medicine.
Blood Coagul Fibrinolysis ; 32(4): 294-297, 2021 Jun 01.
Article in English | MEDLINE | ID: covidwho-1066464
ABSTRACT
Factor V inhibitors are a rare cause of life-threatening bleeding. We present a case of an acquired factor V inhibitor likely caused by coronavirus disease 2019 infection. Bleeding was manifested by severe anemia requiring frequent red-cell transfusion, left psoas muscle hematoma, and left retroperitoneal cavity hematoma. Factor V activity was less than 1% and the factor V inhibitor titer was 31.6 Bethesda units. Severe acute respiratory syndrome coronavirus 2 RNA testing of the nasopharynx was positive 2 weeks before presentation and continued to be positive for 30 days. The patient failed treatment with intravenous immunoglobulin and dexamethasone. Three cycles of plasmapheresis with fresh frozen plasma replacement resulted in correction of the bleeding and laboratory coagulopathy. This is the first reported case of a factor V inhibitor in a coronavirus disease 2019 patient and suggests that plasmapheresis may be a successful treatment strategy.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Autoantibodies / Factor V / SARS-CoV-2 / COVID-19 / Hemorrhagic Disorders Type of study: Case report / Diagnostic study Topics: Long Covid Limits: Female / Humans Language: English Journal: Blood Coagul Fibrinolysis Journal subject: Vascular Diseases / Hematology Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Autoantibodies / Factor V / SARS-CoV-2 / COVID-19 / Hemorrhagic Disorders Type of study: Case report / Diagnostic study Topics: Long Covid Limits: Female / Humans Language: English Journal: Blood Coagul Fibrinolysis Journal subject: Vascular Diseases / Hematology Year: 2021 Document Type: Article