Using Preoperative Therapeutic Plasma Exchange in Lupus Anticoagulant Hypoprothrombinemia Syndrome to Achieve Hemostatic Factor II Activity: A Case Report.

We report a case of a 48-year-old female with lupus anticoagulant hypoprothrombinemia syndrome resulting in a bleeding diathesis due to acquired prothrombin or factor II (factor II) deficiency in the context of very high titers of anti-phosphatidylserine/prothrombin antibodies (anti-PS/PT).

In preparation for elective mitral valve replacement surgery due to infective endocarditis, she received four sessions of therapeutic plasma exchange (therapeutic plasma exchange) preoperatively, followed by IVIG (2 g/kg total in divided doses).

She completed the surgery without bleeding complications.