Treatment of massive cecal bleeding in a 28-Year-old patient with homozygous factor V deficiency with activated factor VII.

Abstract

Factor V deficiency is usually accompanied with recurrent epistaxis, menorrhagia and haemorrhages after trauma. So far, gastrointestinal bleeding has not been reported. We describe here the first case of severe cecal bleeding in a 28-year-old woman with homozygous factor V deficiency. As a reasonable alternative to large amounts of fresh frozen plasma, we indicated recombinant activated factor VII (rFVIIa), as supra-physiological concentrations directly activate factor X and prothrombin on the surface of activated platelets. With this regimen, the bleeding immediately stopped and the patient was discharged three days later. Rotation thromboelastometry studies showed a marked improvement in clot generation after rFVIIa infusion. We conclude that massive cecal mucosal bleeding is a possible manifestation of homozygous factor V deficiency and rFVIIa could be a successful therapy.

• Authors: S Petros, J Fischer, J Mössner, I Schiefke, N Teich
• Journal: Zeitschrift fur Gastroenterologie (Z Gastroenterol) Vol. 46 Issue 3 Pg. 271-3 (Mar 2008) ISSN: 0044-2771 [Print] Germany
• PMID: 18322882 (Publication Type: Case Reports, Journal Article)

Chemical References

• Coagulants
• Factor VIIa

Topics

• Adult
• Cecal Diseases (drug therapy, etiology)
• Coagulants (administration & dosage)
• Factor VII Deficiency (complications, drug therapy)
• Factor VIIa (administration & dosage)
• Female
• Gastrointestinal Hemorrhage (drug therapy, etiology)
• Humans
• Treatment Outcome