The response of an acquired Factor V inhibitor to activated Factor IX concentrate

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Abstract
A 91-yr-old man developed a severe bleeding diathesis postoperatively. Laboratory studies showed an inhibitor to factor V which was identified as IgG. The patient failed to respond to fresh-frozen plasma and platelet transfusions, but demonstrated both clinical and laboratory improvement after transfusion with an activated prothrombin complex concentrate (Autoplex). Patients with refractory inhibitors to factors VIII or IX were managed successfully with this concentrate; this case demonstrates that it also may be of value in managing patients with refractory inhibitors to factor V.