Thrombosis Journal最新文献

{"title":"Case report: Heparin coagulant super-sensitivity during leech therapy.","authors":"Zhan Rong, Adam Daniels, Kevin Luu, Lukasz Czerwonka, Wadie F Bahou","doi":"10.1186/s12959-026-00866-5","DOIUrl":"10.1186/s12959-026-00866-5","url":null,"abstract":"<p><strong>Background: </strong>Leech therapy is used in diverse ways in the medical field, such as for flap salvation and for treatment of osteoarthritis. While bleeding is a recognized adverse effect, severe coagulopathy is rare and underreported, especially when compounded by concurrent anticoagulant use.</p><p><strong>Case presentation: </strong>We present a case of a 76-year-old female undergoing leech therapy in combination with systemic heparin for free flap salvage following partial glossectomy and neck dissection. Shortly after initiating both therapies, the patient developed marked coagulopathy, evidenced by prolonged activated partial thromboplastin time (aPTT), elevated thrombin time, and persistent bleeding from the surgical site. Laboratory results suggested synergistic anticoagulant effects of heparin and hirudin, the potent direct thrombin inhibitor secreted by medicinal leeches. Despite discontinuation of systemic heparin, bleeding persisted until leech therapy was halted. The patient received 8 units of packed red blood cells (pRBCs) during the treatment course. Coagulation markers normalized after cessation of leech therapy, with no further bleeding events.</p><p><strong>Conclusions: </strong>This case highlights a potentially underrecognized risk of coagulopathy in patients undergoing combined leech and systemic anticoagulation therapy. The mechanistically distinct pathways of heparin and hirudin may act synergistically to impair both free and clot-bound thrombin activity. Given the absence of formal guidelines for coagulopathy monitoring in such cases, we propose daily assessment of coagulation markers including aPTT, PT/INR, and a one-time measurement of thrombin time and anti-Xa levels after treatment initiation. This report underscores the need for standardized protocols and further research to guide safe implementation of leech therapy, particularly in patients receiving systemic anticoagulation.</p>","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13285663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fibrinogen-to-albumin ratio and risk of thrombotic diseases incidence.","authors":"Bo Zhu, Xinxin Feng, Bolin Li, Rong Fan, Hui Liu, Xinping Kang, Shuyi Deng, Lele Cheng, Zuyi Yuan, Yue Wu, Tao Zheng","doi":"10.1186/s12959-026-00867-4","DOIUrl":"10.1186/s12959-026-00867-4","url":null,"abstract":"<p><p>BACKGROUND: The fibrinogen-to-albumin ratio (FAR) is linked to cardiovascular diseases, but its association with thrombotic diseases in the general population remains unclear. OBJECTIVE: To investigate the relationship between FAR and thrombotic diseases and assess their dose-response association. METHODS: This prospective cohort study included 18,208 participants (mean age 53.2 years, 41.9% female) from the Xifei community cohort (2011–2021). Participants were categorized into FAR quintiles (Q1–Q5). Restricted cubic spline and Cox regression models were used to assess the associations between FAR and thrombotic risk. RESULTS: Over follow-up of 8 years, 1,373 thrombotic events occurred. Compared to the group of lowest FAR, the group of highest FAR showed significantly increased risks of combined arterial and venous thrombosis (HR = 1.36, 95% CI 1.08–1.70), arterial thrombosis (HR = 1.35, 1.07–1.70), and stroke (HR = 1.36, 1.06–1.76). Risks for acute myocardial infarction, venous thromboembolism, deep venous thrombosis, and pulmonary embolism were not statistically significant. A nonlinear dose-response relationship between FAR and thrombotic risk was observed. CONCLUSIONS AND RELEVANCE: Higher baseline FAR was associated with an elevated risk of arterial and venous thrombosis, arterial thrombosis, and stroke, whereas associations with acute myocardial infarction and venous outcomes (VTE, DVT, and PE) were not statistically significant. These findings suggest that FAR may be a useful biomarker for thrombotic risk assessment in the general population. </p>","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13262508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of direct oral anticoagulants in pediatric congenital and acquired heart disease: a systematic review and meta-analysis of randomized controlled trials.","authors":"Hanan El-Sayed Bakry, Mai Ibrahim Abdellah, Hani Abdelshafook Khalaf, Ahmed Ali Assem, Mohamad Mahmoud ElGamal, Mohamed Ibrahim Abdo, Mohamed Hamouda Elkasaby, Atef A Hassan","doi":"10.1186/s12959-026-00850-z","DOIUrl":"10.1186/s12959-026-00850-z","url":null,"abstract":"<p><p>BACKGROUND: Children with congenital and acquired heart disease (CAHD) are at high risk for venous thromboembolism (VTE). Traditional anticoagulants such as vitamin K antagonists (VKAs) and low-molecular-weight heparin (LMWH) present challenges in pediatrics due to burdensome administration, frequent monitoring, and adherence issues. Direct oral anticoagulants (DOACs) have transformed adult anticoagulation, but their role in pediatric CAHD remains uncertain. OBJECTIVE: To evaluate the efficacy and safety of DOACs compared with standard-of-care (SOC) anticoagulation in pediatric patients with CAHD. METHODS: We systematically searched PubMed, Scopus, Web of Science, and Embase through July 1, 2025. Eligible studies included RCTs comparing DOACs (dabigatran, rivaroxaban, apixaban, edoxaban) with VKAs, LMWH, or aspirin in patients < 18 years with CAHD. Relative risks (RRs) with 95% confidence intervals (CIs) were pooled using random-effects models. Prespecified subgroup analyses were performed for children with congenital heart disease (CHD). RESULTS: Four RCTs, including 732 patients, were analyzed. In the overall population (patients with congenital and acquired heart disease), DOACs significantly reduced thromboembolic events compared to standard-of-care anticoagulation (RR = 0.42, 95% CI: 0.18–0.97; p = 0.04). In the prespecified congenital heart disease (CHD) subgroup, a trend toward reduced events was observed but did not reach statistical significance (RR = 0.29, 95% CI: 0.06–1.29). Individual thromboembolic outcomes (stroke, pulmonary embolism, deep vein thrombosis, and intracardiac thrombus) were rare, with no significant differences between DOAC and control groups in either the overall population or the CHD subgroup (all p > 0.05). Regarding safety, major bleeding rates were similar between DOAC and control groups in the overall population (RR = 0.91, 95% CI: 0.25–3.35) and the CHD subgroup (RR = 1.36, 95% CI: 0.06–32.65). Clinically relevant non-major bleeding was also comparable between DOAC and control groups overall (RR = 0.62, 95% CI: 0.23–1.68) and in the CHD subgroup (RR = 0.75, 95% CI: 0.19–2.49). CONCLUSIONS: DOACs seem to be effective and safe for thromboprophylaxis in pediatric patients with CAHD. They reduce the risk of thromboembolism without increasing bleeding complications. </p>","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":"24 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and associated factors of venous thromboembolism in patients with gastric cancer across treatment settings after diagnosis: a systematic review and meta-analysis.","authors":"Xing Jin, Zhiting Dong, Ningjing Tang, Qingyu Zhang, Jing Li","doi":"10.1186/s12959-026-00864-7","DOIUrl":"10.1186/s12959-026-00864-7","url":null,"abstract":"<p><p>BACKGROUND: Venous thromboembolism (VTE) is a major complication in patients with cancer. Although gastric cancer is recognized as a high-risk malignancy for VTE, existing evidence has mainly focused on perioperative settings. The burden of thrombotic events across broader treatment settings after diagnosis remains less well characterized. This study aimed to estimate the incidence of thrombotic events in patients with gastric cancer across treatment settings after diagnosis and to summarize reported associated factors. METHODS: A systematic review and meta-analysis was conducted in accordance with PRISMA 2020 guidelines. PubMed, Embase, Web of Science, and the Cochrane Library were searched from inception to January 31, 2026. Studies reporting thrombotic event incidence and/or associated factors in patients with pathologically confirmed gastric cancer were included. Random-effects models were applied. Heterogeneity was assessed using the I² statistic. Sensitivity and exploratory subgroup analyses were performed where applicable. RESULTS: Ten studies comprising 9,689 patients were included. In the primary analysis, the pooled incidence of thrombotic events across treatment settings after diagnosis was 9.0% (95% CI 6.1%–13.2%), with substantial heterogeneity (I² = 97.4%). Quantitative analyses of associated factors, including sex, body mass index ≥ 25 kg/m², peritoneal metastasis, lung metastasis, and bone metastasis, did not establish consistent and reproducible independent associations under random-effects models. CONCLUSIONS: Thrombotic risk appears clinically relevant in patients with gastric cancer across treatment settings after diagnosis, beyond short-term perioperative settings. However, current evidence does not establish robust and reproducible predictors for direct clinical implementation. Further large-scale prospective studies are needed to improve risk estimation and support future validation of risk assessment approaches in this population. </p>","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13235215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acquired circulating heparin-like anticoagulants associated with multiple myeloma: three cases reports and literature review.","authors":"Yan Wang, Mingqian Zhang, Feifei Zhang, Yujie Guo, Xuquan Zhou","doi":"10.1186/s12959-026-00863-8","DOIUrl":"10.1186/s12959-026-00863-8","url":null,"abstract":"<p><p>BACKGROUND: Multiple myeloma (MM) is frequently associated with coagulation abnormalities, which can manifest as either thrombotic or hemorrhagic complications. Among these, acquired circulating heparin-like anticoagulants (HLA) leading to extreme prolongation of thrombin time (TT) and spontaneous bleeding are exceedingly rare. Early recognition and appropriate intervention are crucial for patient outcomes. CASES PRESENTATION: Three patients (two males and one female, aged 56–63 years) with confirmed MM presented with spontaneous bleeding manifestations—oral mucosal bleeding, gastrointestinal bleeding, and petechiae of the lower extremities, respectively. All patients exhibited markedly prolonged TT (> 540 s) without a history of heparin exposure. Immunoglobulin levels were elevated (IgG 81.4–137.9 g/L). Coagulation studies showed normal prothrombin time (PT) and mildly prolonged activated partial thromboplastin time (APTT) in two patients, while the third had prolonged PT and APTT. All coagulation factor assays were within normal limits, and lupus anticoagulant testing was negative. Protamine correction tests were positive in all cases, confirming the presence of HLA. Treatment with plasma exchange combined with anti-myeloma regimens (VRD/VCD) led to normalization of TT, cessation of bleeding, and clinical stabilization. CONCLUSION: HLA should be suspected in MM patients with unexplained extreme prolong of TT and bleeding. The protamine correction test is a rapid and effective diagnostic tool. Combined therapy with plasma exchange and treatment of the underlying MM is effective in reversing the coagulopathy and controlling hemorrhage. </p>","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13224442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of patients with protein s deficiency: focus on clinical course and direct oral anticoagulants.","authors":"Nicola Altamura, Filippo Giorgio Di Girolamo, Paola Pradella, Martina Cavalet, Federica Pellicori, Pierandrea Vinci, Emiliano Panizon, Giovanni Cominotto, Michele Zaccari, Irma Galasso, Paola La Rocca, Kaja Teraž, Massimo La Raja, Nicola Fiotti, Gianni Biolo","doi":"10.1186/s12959-026-00861-w","DOIUrl":"10.1186/s12959-026-00861-w","url":null,"abstract":"<p><p>BACKGROUND: Protein S (PS) is a cofactor of protein C (PC) which, when activated to activated PC (APC), mainly acts to degrade coagulation factor Va and VIIIa, and its deficiency may trigger an array of venous thromboembolic events (VTE); when unprovoked and life-threatening, these need indefinite anticoagulation. Direct oral anti coagulants (doac) are efficient drugs in therapy and prevention of VTE, although the optimal prophylactic doses in different conditions are not identified. METHODS: General characteristics and clinical events of 33 PS deficient patients (7 uneventful, 10 carrying also other thrombophilic conditions) were recorded from their medical records. Patients suffering from VTE underwent LMWH/Fondaparinux therapy followed by a full dose of doac (apixaban or rivaroxaban) and then a reduced dose doac (apixaban and rivaroxaban). RESULTS: Average, lowest and highest PS levels measured during follow-up were higher in male patients (p = 0.001). The cumulative prevalence of patients taking drugs acting on central nervous system (opioids, antidepressants, antiepileptic, antimigraine, antipsychotic) was 33%. Three minor hemorrhages were observed during the full-dose and one during the reduced doac therapy, while 3 VTE (1 pulmonary embolism and 2 deep venous thrombosis) occurred exclusively during the reduced-dose doac therapy (p = 0.033 Vs Full dose, 8.1 100patient/yr 95% CI 4–15). Compliance during the reduced-dose therapy was good according to the circulating levels of doac. In survival analysis, the only variable associated with VTE recurrence was PS deficiency combined with thrombophilic defects (p = 0.049). CONCLUSIONS: Free PS deficiency affects the quality of life in many ways and a low dose doac in PS deficient patients is only partially effective in secondary prevention of VTE. </p>","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147654589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acquired dysfibrinogenemia with discordant fibrinogen assays preceding the diagnosis of λ light-chain multiple myeloma: a case report.","authors":"Xuehan Mao, Fan Yu, Yanying Wang, Bianhong Wang, Jingxian Li, Jiao Li, Lihong Li, Yuehua Huang","doi":"10.1186/s12959-026-00862-9","DOIUrl":"10.1186/s12959-026-00862-9","url":null,"abstract":"<p><strong>Background: </strong>Acquired dysfibrinogenemia is a rare and often underrecognized coagulation disorder characterized by impaired fibrinogen function rather than absolute deficiency. In plasma cell dyscrasias, including multiple myeloma, monoclonal gammopathy of undetermined significance, and monoclonal gammopathy of clinical significance, monoclonal immunoglobulins or light chains may interfere with fibrin polymerization, resulting in discordant fibrinogen assay results and diagnostic challenges.</p><p><strong>Case presentation: </strong>A middle-aged woman exhibited persistently prolonged thrombin time (TT) and markedly reduced fibrinogen by the Clauss method, while PT-derived fibrinogen remained relatively preserved, yielding a stable elevated PT-derived/Clauss ratio (~ 4.0-4.7) suggestive of qualitative fibrinogen dysfunction. These abnormalities were detected more than three years before the diagnosis of λ light-chain multiple myeloma (MM), in the absence of CRAB features. Following anti-myeloma therapy, TT and fibrinogen parameters normalized in parallel with hematologic response.</p><p><strong>Conclusions: </strong>This case illustrates that acquired dysfibrinogenemia with discordant fibrinogen assays may serve as an early laboratory clue to an underlying plasma cell dyscrasia and may precede overt multiple myeloma in some patients. Similar coagulation abnormalities may also occur in MGUS or MGCS and should not be interpreted as specific predictors of progression, but rather as potential manifestations of paraprotein-related hemostatic dysfunction.</p>","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13173931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147616797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research advances on platelet glycoprotein VI in ischemic stroke.","authors":"Hanlu Xiang, Ke Ding, Fanqiang Meng, Mengjie Huo, Wentao Yao, Hebo Wang","doi":"10.1186/s12959-026-00859-4","DOIUrl":"10.1186/s12959-026-00859-4","url":null,"abstract":"<p><p>Atherosclerosis is one cause of ischemic stroke. Subcutaneous collagen is exposed when the fibrous cap of an atherosclerotic plaque ruptures. Platelets bind to collagen, leading to platelet activation, aggregation, and thrombus formation. So, antiplatelet agents play a crucial role in the prevention and treatment of ischemic stroke. Nowadays, widely used antiplatelet agents, like aspirin, clopidogrel, and ticagrelor, inhibit thrombus formation while interfering with normal hemostasis, thereby increasing the risk of bleeding. Therefore, there is an urgent need for an antiplatelet agent that can prevent pathological thrombus formation without increasing the risk of bleeding. Glycoprotein Ⅵ (GPⅥ) is a glycoprotein specifically expressed on megakaryocytes and platelets. In patients and mouse models with GPⅥ deficiency, collagen-induced platelet adhesion and aggregation were reduced, resulting in only a mild bleeding tendency. Further research has revealed that targeting GPⅥ can inhibit thrombus formation, reduce thromboinflammation, decrease ischemia-reperfusion injury, and improve neurological deficits. Importantly, targeting GPVI didn’t increase the risk of bleeding or resulted in only minor bleeding. Additionally, its combination with thrombolytic agents, endovascular treatment, or other antiplatelet agents has been proven to be safe and effective. However, Phase II/III trials of agents targeting platelet GPVI failed to demonstrate positive efficacy outcomes in the treatment of ischemic stroke. While GPVI remains a promising antiplatelet target with favorable preclinical and early-phase safety data, clinical efficacy has not yet been demonstrated. Therefore, this review summarizes the potential mechanisms of targeting GPⅥ for antiplatelet therapy and reviews the evidence supporting the benefits of targeting GPⅥ for the prevention, treatment, and prognosis of ischemic stroke. It also summarizes the latest research progress on anti-GPⅥ agents, aiming to bring greater therapeutic benefits to patients with ischemic stroke.</p>","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13151315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147532956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid renal salvage in acute renal vein thrombosis secondary to membranous nephropathy using large-bore mechanical thrombectomy.","authors":"Sanjay Dev Singh, Chye Chung Gan, Limi Lee, Muhammad Syafiq Idris, Ahmad Rafizi Hariz Ramli","doi":"10.1186/s12959-026-00858-5","DOIUrl":"10.1186/s12959-026-00858-5","url":null,"abstract":"<p><p>BACKGROUND: Renal vein thrombosis (RVT) is a rare but serious complication of nephrotic syndrome, particularly in primary membranous nephropathy. Acute RVT with renal impairment and inferior vena cava (IVC) extension carries a high risk of irreversible renal injury. Thrombolysis may be contraindicated due to bleeding risk. CASE PRESENTATION: We report a 56-year-old man who presented with acute left flank pain, gross hematuria, anemia, and acute kidney injury. Investigations revealed nephrotic-range proteinuria and positive anti-phospholipase A2 receptor antibodies, consistent with primary membranous nephropathy. Computed tomography demonstrated extensive left renal vein thrombosis extending into the infrarenal IVC. Due to active hematuria and severe anemia, thrombolysis was contraindicated. Large-bore mechanical thrombectomy using the FlowTriever system was performed with temporary caval protection, achieving complete thrombus removal and restoration of renal venous outflow without thrombolytics. Hematuria resolved immediately and renal function stabilized. CONCLUSION: Large-bore mechanical thrombectomy represents a safe and effective thrombolytic-free option for acute extensive RVT, particularly in nephrotic syndrome patients with high bleeding risk. Early restoration of renal venous outflow may facilitate renal salvage and prevent long-term renal impairment. </p>","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147532900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acquired factor V inhibitor masked by triple antithrombotic therapy presenting as severe gastrointestinal bleeding: a case report.","authors":"Le Yang, Xin Li, Cong Mai","doi":"10.1186/s12959-026-00857-6","DOIUrl":"10.1186/s12959-026-00857-6","url":null,"abstract":"<p><p>We report the case of a 77-year-old male with a history of coronary artery disease, on long-term dual antiplatelet therapy (DAPT) and edoxaban anticoagulation, who presented with severe gastrointestinal bleeding. Laboratory investigations revealed a profound acquired factor V deficiency due to the presence of factor V inhibitors. The patient was successfully treated with transfusion support, immunosuppressive therapy, and continuous renal replacement therapy (CRRT) for fluid management, leading to resolution of symptoms and normalization of coagulation parameters.</p>","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}