대한임상검사과학회지 (Korean Journal of Clinical Laboratory Science)

  • 제54권2호
  • /
  • Pages.163-166
  • /
  • 2022
  • /
  • 1738-3544(pISSN)
  • /
  • 2288-1662(eISSN)
대한임상검사과학회 (Korean Society for Clinical Laboratory Science)
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Diagnosis and Management of Post-Partum Hemorrhage Caused by Acquired Hemophilia A: A Case Report

  • Rashid, Nawshirwan G. (Hiwa Hemato-Oncology Center, Kurdistan Region of Iraq KRI) ;
  • Amin, Shaema Salih (Hiwa Hemato-Oncology Center, Kurdistan Region of Iraq KRI) ;
  • Abdulqader, Aveen M. Raouf (Department of Medical Laboratory Sciences (MLS), American University of Iraq-Sulymaniyah (AUIS))
  • 투고 : 2022.03.03
  • 심사 : 2022.03.23
  • 발행 : 2022.06.30
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초록

Acquired hemophilia A (AHA) is an uncommon autoimmune bleeding disorder in which autoantibodies that affect the functions of factor VIII (FVIII) are present in the blood. The initial diagnosis of AHA is difficult as the presentations of AHA differ from those of congenital hemophilia A. Moreover, the treatment of AHA is more complex due to the presence of autoantibodies against FVIII. Here, we present a case report of postpartum AHA, to increase the perception and knowledge regarding the recognition and management of such cases. We present a young female with the chief complaint of vaginal bleeding and upper arm ecchymosis. Laboratory results exhibited isolated prolonged activated partial thromboplastin time (APTT) and FVIII inhibitors. The patient was treated with corticosteroids, FVIII concentrates, and a bypassing agent. In conclusion, unexplained postpartum bleeding, unmanageable with basic hemostatic measures, should lead to clinical suspicion of an acquired bleeding disease.

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과제정보

We greatly thank the Laboratory staff of Sulaymaniyah Hiwa hemato-oncology Center for their enormous participation and cooperation. Very special thanks and appreciation to management staff of the center for their tremendous role, fruitful ideas, advices, and collaboration.

참고문헌

  1. Ma AD, Carrizosa D. Acquired factor VIII inhibitors: pathophysiology and treatment. Hematology Am Soc Hematol Educ Program. 2006;2006:432-437. https://doi.org/10.1182/asheducation-2006.1.432
  2. Charlebois J, Rivard GE, St-Louis J. Management of acquired hemophilia A: review of current evidence. Transfus Apher Sci. 2018;57:717-720. https://doi.org/10.1016/j.transci.2018.10.011
  3. W Collins P, Chalmers E, Hart D, Jennings I, Liesner R, Rangarajan S, et al. Diagnosis and management of acquired coagulation inhibitors: a guideline from UKHCDO. Br J Haematol. 2013;162:758-773. https://doi.org/10.1111/bjh.12463
  4. Knoebl P, Marco P, Baudo F, Collins P, Huth-Kuhne A, Nemes L, et al. Demographic and clinical data in acquired hemophilia A: results from the European Acquired Haemophilia Registry (EACH2). J Thromb Haemo. 2012;10:622-631. https://doi.org/10.1111/j.1538-7836.2012.04654.x
  5. Sallah S, Wan JY. Inhibitors against factor VIII in patients with cancer. Analysis of 41 patients. Cancer. 2001;91:1067-1074. https://doi.org/10.1002/1097-0142(20010315)91:6<1067::aid-cncr1101>3.0.co;2-4
  6. O'Connor CR. Systematic review of the presentation of coagulation factor VIII inhibitors in rheumatic diseases: a potential cause of life-threatening hemorrhage. Semin Arthritis Rheum. 2015;44:695-709. https://doi.org/10.1016/j.semarthrit.2014.11.008
  7. Green D, Lechner K. A survey of 215 nonhemophilic patients with inhibitors to Factor VIII. Thromb Haemost. 1981;45:200-203. https://doi.org/10.1055/s-0038-1650169
  8. Al-Shbool G, Vakiti A. Acquired hemophilia A presenting as intramuscular hematoma. J Investig Med High Impact Case Rep. 2018;6:1-4. https://doi.org/10.1177/2324709618817572
  9. Franchini M, Mannucci PM. Acquired haemophilia A: a 2013 update. Thromb Haemost. 2013;110:1114-1120. https://doi.org/10.1160/TH13-05-0363
  10. Mulliez SM, Vantilborgh A, Devreese KM. Acquired hemophilia: a case report and review of the literature. Int J Lab Hematol. 2014;36:398-407. https://doi.org/10.1111/ijlh.12210
  11. Borg JY, Guillet B, Le Cam-Duchez V, Goudemand J, Levesque H; SACHA Study Group. Outcome of acquired haemophilia in France: the prospective SACHA (Surveillance des Auto antiCorps au cours de l'Hemophilie Acquise) registry. Haemophilia. 2013;19:564-570. https://doi.org/10.1111/hae.12138
  12. Rinaldi I, Prasetyawaty F, Fazlines S, Winston K, Samudera Nurrobi YA, Leoni J, et al. Diagnosis and management of acquired hemophilia A: case reports and a literature review. Case Rep Med. 2021;2021:5554664 https://doi.org/10.1155/2021/5554664
  13. Collins PW, Percy CL. Advances in the understanding of acquired haemophilia A: implications for clinical practice. Br J Haematol. 2010;148:183-194. https://doi.org/10.1111/j.1365-2141.2009.07915.x
  14. Collins PW, Hirsch S, Baglin TP, Dolan G, Hanley J, Makris M, et al. Acquired hemophilia A in the United Kingdom: a 2-year national surveillance study by the United Kingdom Haemophilia Centre Doctors' Organisation. Blood. 2007;109:1870-1877. https://doi.org/10.1182/blood-2006-06-029850