抜歯後出血を契機に診断された先天性第V因子欠乏症の1例 A case of congenital factor V deficiency detected on bleeding after tooth extraction

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著者

    • 薮田 達雄 YABUTA Tatsuo
    • 和歌山県立医科大学歯科口腔外科学講座 Department of Oral and Maxillofacial Surgery Wakayama Medical University
    • 妙中 泰之 TAENAKA Yasuyuki
    • 和歌山県立医科大学歯科口腔外科学講座 Department of Oral and Maxillofacial Surgery Wakayama Medical University
    • 和田 健 WADA Takeshi
    • 和歌山県立医科大学歯科口腔外科学講座 Department of Oral and Maxillofacial Surgery Wakayama Medical University
    • 森田 展雄 MORITA Nobuo
    • 和歌山県立医科大学歯科口腔外科学講座 Department of Oral and Maxillofacial Surgery Wakayama Medical University
    • 藤田 茂之 FUJITA Shigeyuki
    • 和歌山県立医科大学歯科口腔外科学講座 Department of Oral and Maxillofacial Surgery Wakayama Medical University

抄録

Blood coagulation factor V is a common factor involved in both intrinsic and extrinsic pathways of coagulation; its congenital deficiency is rare. We report a case of congenital factor V deficiency detected because of bleeding after tooth extraction.<br>A 60-year-old man visited our department because of continued bleeding after tooth extraction. We were able to stop the bleeding by local hemostatic measures. However, prothrombin time (PT) was found to be prolonged on a screening blood test. After further evaluation at the Department of Hematology/Oncology, prolongations of both PT and activated partial thromboplastin time (APTT) were confirmed, and the factor V activity was 4.7 %, which is very low. After correction of the PT and APTT values by a cross-mixing test, the possibility of an acquired coagulation factor inhibitor was ruled out. The patient was then given a diagnosis of congenital factor V deficiency.<br>He visited our department again to undergo extraction of the right upper first premolar. After consultation with the Department of Hematology/Oncology, tooth extraction was performed under local anesthesia concurrently with transfusion of fresh frozen plasma.<br>Factor V activity was corrected to 22.3 % from 3.8 %, and the PT and APTT values improved. Postoperative bleeding was controlled by local hemostatic measures using oxidized cellulose and a gingival pack.

Blood coagulation factor V is a common factor involved in both intrinsic and extrinsic pathways of coagulation; its congenital deficiency is rare. We report a case of congenital factor V deficiency detected because of bleeding after tooth extraction.<br>A 60-year-old man visited our department because of continued bleeding after tooth extraction. We were able to stop the bleeding by local hemostatic measures. However, prothrombin time (PT) was found to be prolonged on a screening blood test. After further evaluation at the Department of Hematology/Oncology, prolongations of both PT and activated partial thromboplastin time (APTT) were confirmed, and the factor V activity was 4.7 %, which is very low. After correction of the PT and APTT values by a cross-mixing test, the possibility of an acquired coagulation factor inhibitor was ruled out. The patient was then given a diagnosis of congenital factor V deficiency.<br>He visited our department again to undergo extraction of the right upper first premolar. After consultation with the Department of Hematology/Oncology, tooth extraction was performed under local anesthesia concurrently with transfusion of fresh frozen plasma.<br>Factor V activity was corrected to 22.3 % from 3.8 %, and the PT and APTT values improved. Postoperative bleeding was controlled by local hemostatic measures using oxidized cellulose and a gingival pack.

収録刊行物

  • 日本口腔外科学会雑誌

    日本口腔外科学会雑誌 57(5), 279-283, 2011-05-20

    社団法人 日本口腔外科学会

参考文献:  16件中 1-16件 を表示

各種コード

  • NII論文ID(NAID)
    10030272003
  • NII書誌ID(NCID)
    AN00189163
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    00215163
  • NDL 記事登録ID
    11131922
  • NDL 雑誌分類
    ZS44(科学技術--医学--歯科学・口腔外科学)
  • NDL 請求記号
    Z19-145
  • データ提供元
    CJP書誌  NDL  J-STAGE 
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