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Potential role of thrombelastography in the monitoring of acquired factor VIII inhibitor hemophilia A: report on a 78-year-old woman with life-threatening bleedings. | LitMetric

AI Article Synopsis

  • A 78-year-old woman was hospitalized due to fainting and leg bruising, leading to a diagnosis of acquired hemophilia A (AHA) characterized by low antifactor VIII activity.
  • During her stay, she faced severe bleeding episodes, but treatments with FVIII concentrates and rFVIIa successfully managed these symptoms.
  • Post-treatment, the woman's FVIII inhibitor was eliminated, her blood coagulation profile returned to normal, and it highlighted the need for better laboratory tests to predict bleeding risks in AHA cases, with ROTEM profiles showing promise for monitoring treatment response.

Article Abstract

A 78-year-old woman was admitted to our hospital because of syncope associated with hematomas in both legs. Acquired hemophilia A (AHA) with a low antifactor VIII antibodies activity was diagnosed. Whole blood (WB) thrombelastographic profile depicted a hypocoagulable state. During hospitalization, the patient experienced life-threatening bleedings in the neck and in the right thigh. FVIII concentrates and rFVIIa was safe and effective in controlling acute hemorrhagic symptoms. Immunosuppressive therapy was used successfully to eradicate the inhibitor. At discharge, FVIII inhibitor was absent and thrombelastogram showed a normal profile. Our report confirms that AHA is a heterogeneous condition in terms of risk of bleeding. Even though the criteria for the diagnosis of AHA is quite well defined, a laboratory test useful to predict the bleeding risk and monitor the response to treatment is lacking. ROTEM profile appears to be correlated with the response to treatment and with the eradication of the inhibitor.

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Source
http://dx.doi.org/10.1177/1076029608326167DOI Listing

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