Acquired factor V inhibitor: aetiology, bleeding risk and treatment with regard to three cases.

Introduction. - Acquired factor V inhibitor is rare and clinical symptoms a re quite variable. Bleeding is the leading symptom but some patients are as ymptomatic. Several diseases or conditions are associated with factor V inh ibitors. Various treatments have been attempted but randomized or prospecti ve trials are not available. Exegesis. - Here we report three cases of acquired factor V inhibitor These reports highlight the clinical variability of this disorder. Pathogenesis and therapy with reference to the literature are discussed. Conclusion. - Factor V inhibitors are rare and associated to several diseas es or conditions. Pathogenesis is still unclear except in patients exposed to bovine thrombin. The majority of the cases developed after surgery. In a few cases there is an association to a malignant or autoimmune disease. Pl asmapheresis and platelet transfusions might be the best treatment in case of severe bleeding. High-dose intravenous immunoglobulin infusions have bee n used successfully in some cases and we report here their efficacy in two cases. (C) 2001 Editions scientifiques et medicales Elsevier SAS.