Acquired factor V inhibitor in a case of pediatric venous thrombosis

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 a...

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Main Authors: Sweta Gupta, Matthew W. Bunce, Emily A. Cid, Rodney M. Camire, Amy D. Shapiro
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Research and Practice in Thrombosis and Haemostasis
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Online Access:http://www.sciencedirect.com/science/article/pii/S2475037924003418
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author Sweta Gupta
Matthew W. Bunce
Emily A. Cid
Rodney M. Camire
Amy D. Shapiro
author_facet Sweta Gupta
Matthew W. Bunce
Emily A. Cid
Rodney M. Camire
Amy D. Shapiro
author_sort Sweta Gupta
collection DOAJ
description 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.
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spelling doaj-art-dcea682732e7411bbab06a60d5ac65da2025-08-20T01:57:25ZengElsevierResearch and Practice in Thrombosis and Haemostasis2475-03792025-01-019110264610.1016/j.rpth.2024.102646Acquired factor V inhibitor in a case of pediatric venous thrombosisSweta Gupta0Matthew W. Bunce1Emily A. Cid2Rodney M. Camire3Amy D. Shapiro4Department of Pediatric Hematology, Innovative Hematology, Indiana Hemophilia and Thrombosis Center, Indianapolis, Indiana, USA; Correspondence Sweta Gupta, Innovative Hematology, Indiana Hemophilia and Thrombosis Center, Indianapolis, IN 46260, USA.Division of Hematology and the Raymond G. Perelman Center for Cellular and Molecular Therapeutics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USADivision of Hematology and the Raymond G. Perelman Center for Cellular and Molecular Therapeutics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USADivision of Hematology and the Raymond G. Perelman Center for Cellular and Molecular Therapeutics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USADepartment of Pediatric Hematology, Innovative Hematology, Indiana Hemophilia and Thrombosis Center, Indianapolis, Indiana, USABackground: 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.http://www.sciencedirect.com/science/article/pii/S2475037924003418acquired FV inhibitoranticoagulationdirect oral anticoagulantsfactor V activitythrombosis
spellingShingle Sweta Gupta
Matthew W. Bunce
Emily A. Cid
Rodney M. Camire
Amy D. Shapiro
Acquired factor V inhibitor in a case of pediatric venous thrombosis
Research and Practice in Thrombosis and Haemostasis
acquired FV inhibitor
anticoagulation
direct oral anticoagulants
factor V activity
thrombosis
title Acquired factor V inhibitor in a case of pediatric venous thrombosis
title_full Acquired factor V inhibitor in a case of pediatric venous thrombosis
title_fullStr Acquired factor V inhibitor in a case of pediatric venous thrombosis
title_full_unstemmed Acquired factor V inhibitor in a case of pediatric venous thrombosis
title_short Acquired factor V inhibitor in a case of pediatric venous thrombosis
title_sort acquired factor v inhibitor in a case of pediatric venous thrombosis
topic acquired FV inhibitor
anticoagulation
direct oral anticoagulants
factor V activity
thrombosis
url http://www.sciencedirect.com/science/article/pii/S2475037924003418
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AT emilyacid acquiredfactorvinhibitorinacaseofpediatricvenousthrombosis
AT rodneymcamire acquiredfactorvinhibitorinacaseofpediatricvenousthrombosis
AT amydshapiro acquiredfactorvinhibitorinacaseofpediatricvenousthrombosis