Bovine coagulation factor inhibitors

Coagulation
Acquired bleeding disorders
Bovine coagulation factor inhibitors

Authors: Kendall Crookston, M.D., Ph.D., Lizabeth S. Rosenbaum, M.D., Julie Gober-Wilcox, M.D.

Topic Completed: 1 August 2010

Revised: 4 January 2019, last major update August 2010

Copyright: (c) 2002-2016, PathologyOutlines.com, Inc.

PubMed Search: Bovine coagulation factor inhibitors [title]

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Table of Contents

Definition / general | Laboratory | Case reports | Treatment | Differential diagnosis

Cite this page: Crookston K., Rosenbaum L., Gober-Wilcox J. Bovine coagulation factor inhibitors. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/coagulationbovinecoagulationfactor.html. Accessed February 27th, 2020.

Definition / general

Antibodies that develop against bovine proteins after exposure to topical bovine thrombin preparations which can potentially cross-react with corresponding human coagulation factors
Antibodies can form against bovine thrombin, factor V/Va, and fibrinogen, and less commonly against bovine factors VII and X
Some fibrin glues contain bovine thrombin and cryoprecipitate (containing human fibrinogen)
After use of bovine "fibrin glue" to achieve hemostasis, 1.7% develop a clinically significant inhibitor

Laboratory

Prolonged PT and PTT that does not correct with mixing studies

Case reports

Case reports of 2 children who developed anti-factor V antibodies following bovine thrombin exposure (Pediatr Blood Cancer 2007;49:1025)

Treatment

Steroids, cyclophosphamide, cyclosporine A, IV immunoglobulin
Management of acute bleeding includes plasmapheresis, platelet-transfusions and immunoabsorption

Differential diagnosis