Abstract
This report describes a case of severe coagulopathy and bleeding related to the intraoperative use of topically applied thrombin. Commercial thrombin preparations contaminated with bovine factor V have been shown to stimulate the production of antibodies directed against factor V. These antibodies can cause coagulopathy. Our patient developed antibodies against factor V after intraoperative exposure to topical thrombin. The resulting antibody-mediated depletion of factor V caused a severe and refractory coagulopathy. Vascular surgeons should be aware that the use of topical bovine thrombin can cause severe coagulopathy.
MeSH terms
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Administration, Topical
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Aged
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Aged, 80 and over
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Biomarkers / blood
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Disseminated Intravascular Coagulation / blood
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Disseminated Intravascular Coagulation / chemically induced*
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Disseminated Intravascular Coagulation / diagnostic imaging
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Factor V / metabolism
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Hemostatics / adverse effects*
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Humans
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Intraoperative Care*
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Male
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Partial Thromboplastin Time
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Postoperative Hemorrhage / blood
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Postoperative Hemorrhage / chemically induced
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Postoperative Hemorrhage / diagnostic imaging
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Prothrombin Time
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Severity of Illness Index
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Thrombin / adverse effects*
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Tomography, X-Ray Computed
Substances
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Biomarkers
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Hemostatics
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Factor V
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Thrombin