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Hematology Reports
Volume 10
Issue 3
10.4081/hr.2018.7453
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Hematology Reports is published by MDPI from Volume 14 Issue 1 (2022). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with PAGEPress.
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Case Report

Acquired Hemophilia A Developing Cerebral Infarction 36 Days after the Frequent Administration of Bypass Hemostatic Agents

by
Makoto Saito
1,*,
Hajime Senjo
1,
Minoru Kanaya
1,
Koh Izumiyama
1,
Akio Mori
1,
Masanori Tanaka
1,
Masanobu Morioka
1 and
Masahiro Ieko
2
1
Department of Internal Medicine and Hematology, Aiiku Hospital, Minami 4 Nishi 25 Chuo-ku, Sapporo 064-0804, Japan
2
Department of Internal Medicine, Health Sciences University of Hokkaido, Tobetsu 061-0293, Japan
*
Author to whom correspondence should be addressed.
Hematol. Rep. 2018, 10(3), 7453; https://doi.org/10.4081/hr.2018.7453
Submission received: 16 October 2017 / Revised: 1 June 2018 / Accepted: 24 June 2018 / Published: 5 September 2018

Abstract

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 s) 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.
Keywords: acquired hemophilia A; bypass hemostatic agents; cerebral infarction acquired hemophilia A; bypass hemostatic agents; cerebral infarction

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MDPI and ACS Style

Saito, M.; Senjo, H.; Kanaya, M.; Izumiyama, K.; Mori, A.; Tanaka, M.; Morioka, M.; Ieko, M. Acquired Hemophilia A Developing Cerebral Infarction 36 Days after the Frequent Administration of Bypass Hemostatic Agents. Hematol. Rep. 2018, 10, 7453. https://doi.org/10.4081/hr.2018.7453

AMA Style

Saito M, Senjo H, Kanaya M, Izumiyama K, Mori A, Tanaka M, Morioka M, Ieko M. Acquired Hemophilia A Developing Cerebral Infarction 36 Days after the Frequent Administration of Bypass Hemostatic Agents. Hematology Reports. 2018; 10(3):7453. https://doi.org/10.4081/hr.2018.7453

Chicago/Turabian Style

Saito, Makoto, Hajime Senjo, Minoru Kanaya, Koh Izumiyama, Akio Mori, Masanori Tanaka, Masanobu Morioka, and Masahiro Ieko. 2018. "Acquired Hemophilia A Developing Cerebral Infarction 36 Days after the Frequent Administration of Bypass Hemostatic Agents" Hematology Reports 10, no. 3: 7453. https://doi.org/10.4081/hr.2018.7453

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