Challenges in diagnosis and management of acquired factor V inhibitors

Inhibitors to factor V is a rare phenomenon with varied clinical presentation ranging from asymptomatic states life-threatening bleeds. They are known be associated exposure bovine thrombin, drugs, autoimmune diseases and malignancies. Establishing the diagnosis of FV inhibitors challenging presence lupus-like properties inhibitor can further complicate diagnosis. Here we document an unusual case elderly female posted for pacemaker implantation incidentally, laboratory workup revealed disproportionately abnormal coagulation screen. The intricacies in management discussed along brief review literature. An awareness diverse manifestations this underrecognized disorder difficulties essential medical practitioners, particularly patients idiopathic severe bleeding diathesis.