Acquired Factor V Inhibitor Developing After Percutaneous Ethanol Injection Therapy for Hepatocellular Carcinoma

Yoshitaka Maeda, Naoki Kojima, Yuya Araki, Tomomi Uno, Tamaki Kuyama, Keisuke Nishigaki


    We report a case of an 80-year-old man who showed an abrupt-onset prolongation of the prothrombin time (PT) and activated partial thromboplastin time (APTT) one month after percutaneous ethanol injection therapy (PEIT) for hepatocellular carcinoma. The patient had chronic hepatitis (not liver cirrhosis), but the liver function had been preserved before PEIT. Supplementation of vitamin K and fresh frozen plasma could not restore the coagulation disturbance, and the following examination revealed the existence of factor V inhibitors. Because the patient was positive for hepatitis C virus and concurrent with advanced chronic renal failure, a careful follow-up without any aggressive therapy, such as administration of steroids and other immunosuppressants, was selected. The PT and APTT had been gradually normalized in the following observation period for several months, and no serious event related to bleeding tendency had occurred. This is the first report of factor V inhibitors arising after PEIT that spontaneously diminished by no additional therapy.



Coagulopathy; Prothrombin time; Chronic kidney disease (CKD)

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Journal of Medical Cases, monthly, ISSN 1923-4155 (print), 1923-4163 (online), published by Elmer Press Inc.        
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