Acquired factor V inhibitor after exposure to topical human thrombin related to an otorhinolaryngological procedure

J Thromb Haemost. 2015 Oct;13(10):1787-9. doi: 10.1111/jth.13114. Epub 2015 Sep 30.


Acquired factor V (FV) inhibitors occur rarely and classically develop after exposure to bovine thrombin. The clinical presentation is variable, ranging from asymptomatic with incidental laboratory abnormalities to significant bleeding. With the development of human-derived thrombin agents, bovine thrombin is less frequently used. We report a case of an acquired FV inhibitor that developed in a patient after exposure to human thrombin used as a hemostatic agent during an otorhinolaryngology surgical procedure. Our review of the literature revealed only one prior reported case of FV inhibitor after exposure to human thrombin. Hematologists and surgeons should be aware of this rare, but potentially life-threatening, complication in the postprocedural setting.

Keywords: autoantibodies; bleeding; factor V; hemorrhage; recombinant human thrombin.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Administration, Topical
  • Aged
  • Autoantibodies / blood*
  • Biomarkers / blood
  • Blood Loss, Surgical / prevention & control*
  • Factor V / immunology*
  • Factor V / metabolism
  • Factor V Deficiency / blood
  • Factor V Deficiency / chemically induced*
  • Factor V Deficiency / diagnosis
  • Factor V Deficiency / immunology
  • Female
  • Hemostatics / administration & dosage
  • Hemostatics / adverse effects*
  • Humans
  • Otorhinolaryngologic Surgical Procedures* / adverse effects
  • Postoperative Hemorrhage / prevention & control*
  • Thrombin / administration & dosage
  • Thrombin / adverse effects*
  • Time Factors


  • Autoantibodies
  • Biomarkers
  • Hemostatics
  • Factor V
  • Thrombin