MULTIMODALITY THERAPY OF AN ACQUIRED FACTOR-V INHIBITOR

Acquired inhibitors of factor V are rare causes of clinical bleeding, whose severity ranges from mild to life-threatening. Optimal treatment of patients with factor V inhibitors is uncertain. We report on our s uccessful treatment approach in a patient with spontaneous, life-threa tening intracranial bleeding caused by a factor V inhibitor. The patie nt deteriorated after initial treatment with fresh-frozen plasma and p latelet transfusions. He was subsequently treated with a combination o f plasma exchange and chemotherapy, which led to complete recovery. Ou r experience suggests that plasma exchange may be lifesaving in cases of severe bleeding caused by factor V inhibitors. The use of plasmaphe resis in conjunction with chemotherapy is an efficacious and well-tole rated treatment and should be considered in patients with factor V inh ibitors. (C) 1996 Wiley-Liss, Inc.