Acquired factor V inhibitor masked by triple antithrombotic therapy presenting as severe gastrointestinal bleeding: a case report

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.