SEVERE BLEEDING CAUSED BY AN INHIBITOR TO COAGULATION-FACTOR-V - A CASE-REPORT

A 67-year-old man with a severe bleeding due to a high level of factor V inhibitor (maximum level of 350 Bethesda units) is described. Coagu lation abnormalities improved initially during treatment with predniso lone in combination with cyclophosphamide. Subsequent treatment with e ither cyclophosphamide or cyclosporin alone was ineffective. After mor e than 2 years the inhibitor became undetectable after a prolonged per iod of high dose steroid therapy, but the patient remained steroid dep endent. Therapeutic strategies for patients having a factor V inhibito r are discussed.