ACQUIRED CIRCULATING ANTICOAGULANT WITH ANTI-FACTOR-V ACTIVITY IN AIDS - FIRST CASE-REPORT

An acquired circulating anticoagulant with anti-factor V activity appe ared in a 29 year old AIDS patient with widespread Kaposi's sarcoma fo llowing 21 days of fresh frozen plasma therapy for haemolytic and urae mic syndrome. Residual factor V activity was very low (< 5% of normal) . However, the inhibitor was of low titre (0.5 Bethesda Units/ml), whi le antigenic factor V levels remained at 100%. Dot blotting with human factor V and polyvalent and specific immunoglobulin antisera showed t he antibody to belong to the IgG class. Haemostatic tests in vitro wer e only partly corrected by addition of washed human platelets and desp ite transfusion of large amounts of platelets the patient died from ma ssive pulmonary haemorrhage. This would appear to be the first documen ted case of an anti-factor V inhibitor occurring in an AIDS patient.