Successful Management of Severe Intraperitoneal Hemorrhage by Platelet Transfusion in a Patient with Acquired Factor V Inhibitor
A 68-year-old Japanese woman was admitted to our hospital because of macroscopic hematuria and intraperitoneal bleeding. There was no history of coagulopathy or blood transfusion. Factor V activity was markedly decreased to less than 1.0 per cent and the corrected prothrombin time test suggested the presence of an inhibitor to Factor V. Her intraperitoneal bleeding was. eventually controlled by transfusion of platelet concentrate, after transfusion of fresh frozen plasma and administration of prednisolone had shown no effect. No underlying disease, such as malignancy or autoimmunity, was found in this patient. Bleeding is reported to be mild in the majority of patients with acquired Factor V inhibitor, but it is also sometimes fatal, so prompt diagnosis and treatment of this condition are necessary. Platelet transfusion may be useful for controlling severe hemorrhage in these patients.