Acquired hemophilia A manifesting as plasma transfusion-uncontrolled severe bleeding 2 weeks after chorioamnionitis-induced abortion
| Autor: | Ayumi Matsuoka, Hiromasa Sasaki, Shinya Hirabuki, Hiroshi Fujiwara, Tsutomu Hoshiba, Chiharu Sugimori |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Pregnancy medicine.diagnostic_test business.industry Obstetrics and Gynecology 030204 cardiovascular system & hematology Abortion medicine.disease Chorioamnionitis Miscarriage Surgery 03 medical and health sciences 0302 clinical medicine Anesthesia medicine Vaginal bleeding Fresh frozen plasma medicine.symptom business Complication 030215 immunology Partial thromboplastin time |
| Zdroj: | Journal of Obstetrics and Gynaecology Research. 43:763-767 |
| ISSN: | 1341-8076 |
| DOI: | 10.1111/jog.13270 |
| Popis: | Acquired hemophilia A (AHA) is a serious and rare complication of pregnancy, caused by autoantibodies to coagulation factor VIII after delivery. We here report the case of a 36-year-old primigravida woman who developed AHA following chorioamnionitis-caused miscarriage in the second trimester. Thirteen days after abortion, sudden, massive vaginal bleeding occurred with marked prolongation of activated partial thromboplastin time (APTT) in the absence of other abnormal coagulation data. Sequential transfusion of fresh frozen plasma did not achieve normalization of APTT. Further examination confirmed reduction of coagulation factor VIII and the presence of its inhibitor, leading to the final diagnosis of AHA. The patient was effectively treated with bypassing agents (activated prothrombin complex concentrate and recombinant activated factor VII) and immunosuppressive therapy. Fifteen months after remission, the patient became pregnant and successfully achieved term delivery with no signs of recurrence. This case illustrates that AHA should be considered in the occurrence of plasma transfusion-uncontrolled severe bleeding after delivery. |
| Databáze: | OpenAIRE |
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