The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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Antibiotic-Induced Acquired Factor V Inhibitor

항생제 치료로 유발된 혈액응고 제V인자에 대한 후천적 억제인자

  • Lim, Doo-Ho (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Tae-Oh (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jeong, Yumun (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Won-Jang (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, Seung-Jung (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Je-Hwan (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jang, Sung-Soo (Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • 임두호 (울산대학교 의과대학 서울아산병원 내과) ;
  • 김태오 (울산대학교 의과대학 서울아산병원 내과) ;
  • 정유문 (울산대학교 의과대학 서울아산병원 내과) ;
  • 김원장 (울산대학교 의과대학 서울아산병원 내과) ;
  • 박승정 (울산대학교 의과대학 서울아산병원 내과) ;
  • 이제환 (울산대학교 의과대학 서울아산병원 내과) ;
  • 장성수 (울산대학교 의과대학 서울아산병원 진단검사의학과)
  • Received : 2013.08.21
  • Accepted : 2013.10.04
  • Published : 2014.07.01
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Abstract

Acquired factor V inhibitor is a rare condition with a variety of clinical manifestations that range from no bleeding symptoms to life-threatening hemorrhage or thromboembolic events. Treatment is determined by the clinical course and focuses on controlling the hemorrhagic event and decreasing the antibody titer if bleeding symptoms are present. We report herein a case involving a 70-year-old man who developed acquired factor V inhibitor after antibiotic administration (11-day course of ceftriaxone and successive 5-day course of piperacillin-tazobactam) for pneumonia. His condition was characterized by elevated prothrombin and activated partial thromboplastin times without bleeding events. Coagulation factor assays revealed undetectable factor V activity and a factor V inhibitor level of 3.29 Bethesda units. After cessation of the antibiotics, both the prothrombin and activated partial thromboplastin times gradually normalized.

후천성 제V인자 억제인자는 드문 응고 장애 질환으로 무증상에서 중증 출혈 혹은 혈전증과 같은 다양한 임상 상을 보인다. 수술 전과 수술 중 우형 트롬빈의 사용, 항생제, 수혈, 최근의 수술, 악성 종양, 자가 면역 질환 등과 연관되어 발생하는 것으로 알려져 있으며 특별한 선행요인 없이 특발성으로 발현되기도 한다. 저자들은 다른 선행요인 없이 항생제 투여 후 제V인자 억제인자가 유발된 증례를 경험하였고 이는 국내에서 보고된 예가 없기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

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