{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T04:47:30Z","timestamp":1780634850402,"version":"3.54.1"},"reference-count":30,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,12,1]]},"abstract":"<jats:p>Historically, inhibitors to coagulation factor V (FV) most often have developed in patients treated with bovine thrombin, a topical hemostatic agent used during surgical procedures. With the advent of newer hemostatic agents, and the concurrent diminished use of bovine thrombin, the incidence of FV inhibitors has fallen. Nevertheless, FV inhibitors are occasionally seen on an idiopathic basis as well as in association with medications, malignancies, autoimmune disorders, pregnancy, and infections. Factor V inhibitors may present with life-threatening bleeding or thrombosis, or they may be discovered incidentally as a coagulation screening test abnormality. Management of patients with FV inhibitors is challenging and consists of control of bleeding and eradication of the inhibitor. In this short overview we review the role of platelet and plasma FV in hemostasis and discuss the unique characteristics, clinical features, diagnosis, treatment, and prognosis associated with FV inhibitors.<\/jats:p>","DOI":"10.5858\/arpa.2016-0445-rs","type":"journal-article","created":{"date-parts":[[2017,11,30]],"date-time":"2017-11-30T09:28:34Z","timestamp":1512034114000},"page":"1728-1731","source":"Crossref","is-referenced-by-count":23,"title":["Factor V Inhibitors: A Diagnostic and Therapeutic Challenge"],"prefix":"10.5858","volume":"141","author":[{"given":"Nicholas J.","family":"Olson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah L.","family":"Ornstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3906","reference":[{"issue":"5","key":"2020081219331354300_i1543-2165-141-12-1728-b01","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1160\/TH08-11-0767","article-title":"Acquired factor V inhibitor: a problem-based systematic review","volume":"101","author":"Ang","year":"2009","journal-title":"Thromb Haemost"},{"issue":"8","key":"2020081219331354300_i1543-2165-141-12-1728-b02","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1097\/00001721-200412000-00003","article-title":"Factor V inhibitors: rare or not so uncommon: a multi-laboratory investigation","volume":"15","author":"Favaloro","year":"2004","journal-title":"Blood Coagul Fibrinolysis"},{"issue":"1","key":"2020081219331354300_i1543-2165-141-12-1728-b03","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1046\/j.1537-2995.2002.00011.x","article-title":"Acquired FV inhibitors: a needless iatrogenic complication of bovine thrombin exposure","volume":"42","author":"Streiff","year":"2002","journal-title":"Transfusion"},{"issue":"5\u20136","key":"2020081219331354300_i1543-2165-141-12-1728-b04","first-page":"357","article-title":"An acquired factor V inhibitor: clinical and laboratory features","volume":"30","author":"Shastri","year":"1999","journal-title":"J Med"},{"issue":"suppl 1","key":"2020081219331354300_i1543-2165-141-12-1728-b05","first-page":"S29","article-title":"Bovine thrombin: history, use, and risk in the surgical patient","volume":"16","author":"Diesen","year":"2008","journal-title":"Vascular"},{"issue":"4","key":"2020081219331354300_i1543-2165-141-12-1728-b06","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1007\/s11239-010-0529-6","article-title":"Acquired factor V inhibitors: a systematic review","volume":"31","author":"Franchini","year":"2011","journal-title":"J Thromb Thrombolysis"},{"issue":"4","key":"2020081219331354300_i1543-2165-141-12-1728-b07","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1177\/1076029606293438","article-title":"Spectrum of bleeding in acquired factor V inhibitor: a summary of 33 cases","volume":"12","author":"Wiwanitkit","year":"2006","journal-title":"Clin Appl Thromb Hemost"},{"issue":"4","key":"2020081219331354300_i1543-2165-141-12-1728-b08","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1002\/ajh.2830420410","article-title":"Factor V inhibitor in thrombosis","volume":"42","author":"Kapur","year":"1993","journal-title":"Am J Hematol"},{"issue":"11","key":"2020081219331354300_i1543-2165-141-12-1728-b09","doi-asserted-by":"crossref","first-page":"4188","DOI":"10.1182\/blood.V91.11.4188","article-title":"Inhibitory anti-factor V antibodies bind to the factor V C2 domain and are associated with hemorrhagic manifestations","volume":"91","author":"Ortel","year":"1998","journal-title":"Blood"},{"issue":"1","key":"2020081219331354300_i1543-2165-141-12-1728-b10","first-page":"73","article-title":"Identification of factor inhibitors by diagnostic haemostasis laboratories: a large multi-centre evaluation","volume":"96","author":"Favaloro","year":"2006","journal-title":"Thromb Haemost"},{"key":"2020081219331354300_i1543-2165-141-12-1728-b11","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/B978-141602401-9.10006-9","article-title":"Nonhemophilic inhibitors of coagulation","author":"Ewenstein","year":"2007","journal-title":"Consultative Hemostasis and Thrombosis. 2nd ed"},{"issue":"2","key":"2020081219331354300_i1543-2165-141-12-1728-b12","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1002\/(SICI)1096-8652(199802)57:2<176::AID-AJH14>3.0.CO;2-A","article-title":"Deep-vein thrombosis and coumarin skin necrosis associated with a factor V inhibitor with lupus-like features","volume":"57","author":"Kamphuisen","year":"1998","journal-title":"Am J Hematol"},{"issue":"11","key":"2020081219331354300_i1543-2165-141-12-1728-b13","doi-asserted-by":"crossref","first-page":"1831","DOI":"10.1007\/s00277-012-1485-3","article-title":"Deep vein thrombosis associated with factor V inhibitor followed by immune thrombocytopenia","volume":"91","author":"Higuchi","year":"2012","journal-title":"Ann Hematol"},{"issue":"1","key":"2020081219331354300_i1543-2165-141-12-1728-b14","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1002\/ajh.2830490122","article-title":"Coagulopathy due to an acquired factor V inhibitor and subsequently thrombosis","volume":"49","author":"George","year":"1995","journal-title":"Am J Hematol"},{"key":"2020081219331354300_i1543-2165-141-12-1728-b15","doi-asserted-by":"crossref","first-page":"27","DOI":"10.2147\/IMCRJ.S59236","article-title":"Acquired factor V inhibitor in a patient with mantle cell lymphoma presenting with hematuria followed by thrombosis: a case report","volume":"7","author":"Aljohani","year":"2014","journal-title":"Int Med Case Rep J"},{"issue":"7","key":"2020081219331354300_i1543-2165-141-12-1728-b16","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1097\/01.mbc.0000245297.64644.ee","article-title":"Platelet factor V supports hemostasis in a patient with an acquired factor V inhibitor, as shown by prothrombinase and tenase assays","volume":"17","author":"Perdekamp","year":"2006","journal-title":"Blood Coagul Fibrinolysis"},{"issue":"5","key":"2020081219331354300_i1543-2165-141-12-1728-b17","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1046\/j.1538-7836.2003.00143.x","article-title":"Anti-factor V auto-antibody in the plasma and platelets of a patient with repeated gastrointestinal bleeding","volume":"1","author":"Ajzner","year":"2003","journal-title":"J Thromb Haemost"},{"issue":"2","key":"2020081219331354300_i1543-2165-141-12-1728-b18","first-page":"612","article-title":"Proceedings: a more uniform measurement of factor VIII inhibitors","volume":"34","author":"Kasper","year":"1975","journal-title":"Thromb Diath Haemorrh"},{"issue":"9","key":"2020081219331354300_i1543-2165-141-12-1728-b19","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1309\/35F9-R8HN-V6NQ-WRY2","article-title":"Acquired factor V inhibitor with lupus-like features","volume":"33","author":"Wang","year":"2002","journal-title":"Lab Med"},{"issue":"1","key":"2020081219331354300_i1543-2165-141-12-1728-b20","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1097\/MBC.0b013e328359bc59","article-title":"Acquired factor V inhibitor developing in a patient with esophageal squamous cell carcinoma","volume":"24","author":"Ahmadinejad","year":"2013","journal-title":"Blood Coagul Fibrinolysis"},{"key":"2020081219331354300_i1543-2165-141-12-1728-b21","doi-asserted-by":"publisher","DOI":"10.1097.MBC0000000000000603","article-title":"Fatal hemorrhage due to a spontaneous factor V inhibitor with lupus anticoagulant properties","author":"Olson","year":"2016]","journal-title":"Blood Coagul Fibrinolysis"},{"issue":"3","key":"2020081219331354300_i1543-2165-141-12-1728-b22","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1055\/s-0038-1646741","article-title":"Acquired inhibitors of factor V","volume":"39","author":"Feinstein","year":"1978","journal-title":"Thromb Haemost"},{"issue":"6","key":"2020081219331354300_i1543-2165-141-12-1728-b23","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1016\/j.thromres.2012.09.004","article-title":"Assessment of the impact of rivaroxaban on coagulation assays: laboratory recommendations for the monitoring of rivaroxaban and review of the literature","volume":"130","author":"Douxfils","year":"2012","journal-title":"Thromb Res"},{"key":"2020081219331354300_i1543-2165-141-12-1728-b24","first-page":"179","article-title":"and factor VIII","author":"Kaufman","year":"2013","journal-title":"Hemostasis and Thrombosis, Basic Principles and Clinical Practice. 6th ed"},{"issue":"3","key":"2020081219331354300_i1543-2165-141-12-1728-b25","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1016\/S0304-4157(98)00018-5","article-title":"Lipid-protein interactions in blood coagulation","volume":"1376","author":"Zwaal","year":"1998","journal-title":"Biochim Biophys Acta"},{"issue":"3","key":"2020081219331354300_i1543-2165-141-12-1728-b26","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1159\/000345244","article-title":"Successful management of a possible antibiotic-related acquired factor V inhibitor: a case report and review of the literature","volume":"129","author":"Motwani","year":"2013","journal-title":"Acta Haematol"},{"issue":"4","key":"2020081219331354300_i1543-2165-141-12-1728-b27","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1172\/JCI111531","article-title":"(Quebec): a bleeding diathesis associated with a qualitative platelet factor V deficiency","volume":"74","author":"Tracy","year":"1984","journal-title":"J Clin Invest"},{"issue":"2","key":"2020081219331354300_i1543-2165-141-12-1728-b28","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1172\/JCI112318","article-title":"Isolation and study of an acquired inhibitor of human coagulation factor V","volume":"77","author":"Nesheim","year":"1986","journal-title":"J Clin Invest"},{"issue":"3","key":"2020081219331354300_i1543-2165-141-12-1728-b29","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1111\/j.1538-7836.2005.01157.x","article-title":"Megakaryocytes endocytose and subsequently modify human factor V in vivo to form the entire pool of a unique platelet-derived cofactor","volume":"3","author":"Gould","year":"2005","journal-title":"J Thromb Haemost"},{"issue":"1","key":"2020081219331354300_i1543-2165-141-12-1728-b30","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1111\/vox.12134","article-title":"Management of bleeding in severe factor V deficiency with a factor V inhibitor","volume":"107","author":"Ardillon","year":"2014","journal-title":"Vox Sang"}],"container-title":["Archives of Pathology &amp; Laboratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/meridian.allenpress.com\/aplm\/article-pdf\/141\/12\/1728\/1445523\/arpa_2016-0445-rs.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/meridian.allenpress.com\/aplm\/article-pdf\/141\/12\/1728\/1445523\/arpa_2016-0445-rs.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T19:38:39Z","timestamp":1764790719000},"score":1,"resource":{"primary":{"URL":"https:\/\/aplm.kglmeridian.com\/view\/journals\/arpa\/141\/12\/article-p1728.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12,1]]},"references-count":30,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2017,12,1]]}},"URL":"https:\/\/doi.org\/10.5858\/arpa.2016-0445-rs","relation":{},"ISSN":["0003-9985","1543-2165"],"issn-type":[{"value":"0003-9985","type":"print"},{"value":"1543-2165","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,12,1]]}}}