Confirmation and characterization of factor V inhibitor
The patient should not be on anticoagulant therapy
Frozen (preferred) – 30 days
Ambient – 4 hours
Refrigerated – NO
The factor V inhibitor (Bethesda titer) assay is performed using a prothrombin time-based system, using thromboplastin reagent.6 Serial dilutions are made of patient plasma with veronal buffered saline, then mixed with normal plasma containing close to 100% factor V activity, and are then incubated for two hours. A PT-based factor V assay using factor V-depleted plasma substrate is then performed on these incubated mixtures. Results are compared to those of incubated normal plasma. One Bethesda unit is defined as the amount of factor V inhibitor that neutralized 0.5 IU of factor V in this system. The number of serial dilutions tested is based on the anticipated level of the inhibitor.
Prothrombin Time / PT 1:1 NP
0 - 3 d: 10.7 - 15.6 sec
4 d - 6 m: 10.4 - 13.9 sec
7 m - 17 y: 10.1 - 12.7 sec
≥18 y: 9.6 - 11.5 sec
APTT
0 - 3 d: not established
4 d - 6 m: 23.1 - 32.5 sec
7 m - 17 y: 23.1 - 30.1 sec
≥18 y: 22.9 - 30.2 sec
Factor V activity
0 - 3 d: not established
4 d - 6 m: 34 - 108 %
≥7 m: 23.1 - 30.1 sec
Facator V inact assay
<0.8 Bethesda