Acquired hemophilia A developing cerebral infarction 36 days after the frequent administration of bypass hemostatic agents
A 74-years-old male who was a smoker and received treatment for hypertension, dyslipidemia, peripheral arterial disease and idiopathic interstitial pneumonia complained of subcutaneous hemorrhage of the right lower thigh. Marked anemia (hemoglobin 5.5 g/dL) and prolonged activated partial thrombopla...
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doaj-a353d64a272d4f9fac537e0cc1d1e72c2020-11-25T03:18:31ZengPAGEPress PublicationsHematology Reports2038-83222038-83302018-09-0110310.4081/hr.2018.74533966Acquired hemophilia A developing cerebral infarction 36 days after the frequent administration of bypass hemostatic agentsMakoto Saito0Hajime Senjo1Minoru Kanaya2Koh Izumiyama3Akio Mori4Masanori Tanaka5Masanobu Morioka6Masahiro Ieko7Department of Internal Medicine and Hematology, Aiiku HospitalDepartment of Internal Medicine and Hematology, Aiiku HospitalDepartment of Internal Medicine and Hematology, Aiiku HospitalDepartment of Internal Medicine and Hematology, Aiiku HospitalDepartment of Internal Medicine and Hematology, Aiiku HospitalDepartment of Internal Medicine and Hematology, Aiiku HospitalDepartment of Internal Medicine and Hematology, Aiiku HospitalDepartment of Internal Medicine, Health Sciences University of HokkaidoA 74-years-old male who was a smoker and received treatment for hypertension, dyslipidemia, peripheral arterial disease and idiopathic interstitial pneumonia complained of subcutaneous hemorrhage of the right lower thigh. Marked anemia (hemoglobin 5.5 g/dL) and prolonged activated partial thromboplastin time (≥130 seconds) were noted. The factor VIII activity level was reduced to 1.2%, and the factor VIII inhibitor titer was 285.3 BU/mL, a diagnosis of acquired hemophilia A (AHA) was made. Then, hematomas of 5 intra-muscles were recurred. Hemostasis became difficult despite frequent and high-dose administration of recombinant human coagulation factor VIIa (total: 18 days, 305 mg). Hemostasis was achieved by switching to activated prothrombin complex concentrate (for 3 days, 18,000 units), however, cerebral infarction occurred after 36 days. After the frequent administration of bypass hemostatic agents on elderly AHA patients with several risk factors for ischemic stroke, the risk of subsequent thrombotic events may persist for 1 month.https://www.pagepress.org/journals/index.php/hr/article/view/7453Acquired hemophilia Abypass hemostatic agentscerebral infarction. |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Makoto Saito Hajime Senjo Minoru Kanaya Koh Izumiyama Akio Mori Masanori Tanaka Masanobu Morioka Masahiro Ieko |
spellingShingle |
Makoto Saito Hajime Senjo Minoru Kanaya Koh Izumiyama Akio Mori Masanori Tanaka Masanobu Morioka Masahiro Ieko Acquired hemophilia A developing cerebral infarction 36 days after the frequent administration of bypass hemostatic agents Hematology Reports Acquired hemophilia A bypass hemostatic agents cerebral infarction. |
author_facet |
Makoto Saito Hajime Senjo Minoru Kanaya Koh Izumiyama Akio Mori Masanori Tanaka Masanobu Morioka Masahiro Ieko |
author_sort |
Makoto Saito |
title |
Acquired hemophilia A developing cerebral infarction 36 days after the frequent administration of bypass hemostatic agents |
title_short |
Acquired hemophilia A developing cerebral infarction 36 days after the frequent administration of bypass hemostatic agents |
title_full |
Acquired hemophilia A developing cerebral infarction 36 days after the frequent administration of bypass hemostatic agents |
title_fullStr |
Acquired hemophilia A developing cerebral infarction 36 days after the frequent administration of bypass hemostatic agents |
title_full_unstemmed |
Acquired hemophilia A developing cerebral infarction 36 days after the frequent administration of bypass hemostatic agents |
title_sort |
acquired hemophilia a developing cerebral infarction 36 days after the frequent administration of bypass hemostatic agents |
publisher |
PAGEPress Publications |
series |
Hematology Reports |
issn |
2038-8322 2038-8330 |
publishDate |
2018-09-01 |
description |
A 74-years-old male who was a smoker and received treatment for hypertension, dyslipidemia, peripheral arterial disease and idiopathic interstitial pneumonia complained of subcutaneous hemorrhage of the right lower thigh. Marked anemia (hemoglobin 5.5 g/dL) and prolonged activated partial thromboplastin time (≥130 seconds) were noted. The factor VIII activity level was reduced to 1.2%, and the factor VIII inhibitor titer was 285.3 BU/mL, a diagnosis of acquired hemophilia A (AHA) was made. Then, hematomas of 5 intra-muscles were recurred. Hemostasis became difficult despite frequent and high-dose administration of recombinant human coagulation factor VIIa (total: 18 days, 305 mg). Hemostasis was achieved by switching to activated prothrombin complex concentrate (for 3 days, 18,000 units), however, cerebral infarction occurred after 36 days. After the frequent administration of bypass hemostatic agents on elderly AHA patients with several risk factors for ischemic stroke, the risk of subsequent thrombotic events may persist for 1 month. |
topic |
Acquired hemophilia A bypass hemostatic agents cerebral infarction. |
url |
https://www.pagepress.org/journals/index.php/hr/article/view/7453 |
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