Acquired Hemophilia : Report of Three Cases
Keywords:
Acquired hemophilia, Hemophilia, Factor VIII inhibitorAbstract
Abstract : Acquired hemophilia is a rare bleeding disorder whose incidence is is 0.2-1 per milion a year. Familiarity of this disorder is a maior problem in managing these patients. This study reports 3 cases of acquired hemophilia in 35 years. All of them are old female (more than 50 years old). No underlying disease is found except diabetes mellitus in one patient. The most common presenting symptoms are gingival bleeding and ecchymoses. Screening coagulogram shows isolated APTT prolongation, which cannot be corrected by normal plasma. Their factor VIII:C are 2, 4 and 46% and factor VII inhibitor level are 5, 66 and 512 bethesda units respectively. Immuncsuppressive is the promising ing tment. Although one patient whose factor Vill inhibitor level is as high as 512 bethesda unit, she also response very well to combined immunosuporessives. Bleeding problem is resolved within 5-7 days and the inhibitor cannot be detected within 2-3 weeks in every patient. Complete remission can be achieved by contiual immunosuppressives but no more than 3-6 months No replacement therapy for raising factor VIII level is needed in all of them. No bleeding complication or myelosuppression are detected.
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