Research and practice in thrombosis and haemostasis · 2024
Acquired factor V inhibitor in a case of pediatric venous thrombosis.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Gupta Sweta, Bunce Matthew W, Cid Emily A, Camire Rodney M, Shapiro Amy D
Аннотация
BACKGROUND: The development of acquired factor (F)V with inhibitor (AFVwI) is rare, resulting mainly in bleeding complications, although sporadic cases of thrombosis in adults have been reported.
KEY CLINICAL QUESTION: How do you diagnose and manage a pediatric case of acute deep venous thrombosis associated with the concurrent finding of AFVwI?
CLINICAL APPROACH: A 13-year-old female with Crohn's Disease and May-Thurner anatomy developed extensive deep venous thrombosis of the left lower extremity, complicated by the finding of AFVwI, discovered during the evaluation of a prolonged prothrombin time and a low FV activity. Anticoagulation was initiated with low-molecular-weight heparin followed by a direct oral anticoagulant, rivaroxaban, without any complications. AFVwI was undetectable after 5 months with normalization of FV activity.
CONCLUSION: Our case highlights the first pediatric case of thrombosis with a rare finding of AFVwI, successfully managed with anticoagulation therapy with complete resolution.
KEY CLINICAL QUESTION: How do you diagnose and manage a pediatric case of acute deep venous thrombosis associated with the concurrent finding of AFVwI?
CLINICAL APPROACH: A 13-year-old female with Crohn's Disease and May-Thurner anatomy developed extensive deep venous thrombosis of the left lower extremity, complicated by the finding of AFVwI, discovered during the evaluation of a prolonged prothrombin time and a low FV activity. Anticoagulation was initiated with low-molecular-weight heparin followed by a direct oral anticoagulant, rivaroxaban, without any complications. AFVwI was undetectable after 5 months with normalization of FV activity.
CONCLUSION: Our case highlights the first pediatric case of thrombosis with a rare finding of AFVwI, successfully managed with anticoagulation therapy with complete resolution.