A Case of Acquired Hemophilia A with Maxillary Osteitis
Journal Title: Macedonian Journal of Medical Sciences (MJMS) - Year 2012, Vol 5, Issue 4
Abstract
Acquired hemophilia A (AHA), is a rare bleeding disorder with an incidence of approximately 1 per million/year.The disease is caused by the development of autoantibodies directed against clotting factor VIII and associated with an increased morbidity and mortality. In 50% of cases, FVIII autoantibodies occur in patients lacking any relevant concomitant disease; the remaining cases may be associated with postpartum period, autoimmune diseases, underlying hematologic or solid cancers, and infections. We report the case of a 32-years-old woman, admitted in hemorrhagic shock, following a non-reversible bleeding after dental extraction. The Laboratory tests prolonged activated prothrombin thromboplastin time (APTT at 54s), and normal Prothombine time (PT at 75%). The mixing test revealed the presence of a circulating anticoagulant with a Rosner index at 15. Factors specific to the intrinsic pathway determined that the patient had a factor VIII deficiency. Acquired hemophilia was diagnosed. At the local level, CT scan of the face objectified a right maxillary osteitis without sinus damage.The patient received transfusion of Red Blood Cells units and FFP (fresh frozen plasma) concentrates.but kept bleeding until an antibiotic treatment and corticosteroids (60mg/d) were added.
Authors and Affiliations
Omar EL Graoui| From the Department of Hematology Laboratory, Ibn Rushd Teaching Hospital, Casablanca University, Morrocoo, Saadia Faez| From the Department of Hematology Laboratory, Ibn Rushd Teaching Hospital, Casablanca University, Morrocoo, Bouchra Oukkache| From the Department of Hematology Laboratory, Ibn Rushd Teaching Hospital, Casablanca University, Morrocoo
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