Unsuspected acquired hemophilia in a patient with severe postpartum hemorrhage

Autor: Babasaheb Raosaheb Desai, Yeshita Pujar, Bhavana Y Sherigar, Shobhana Suresh Patted, Jayashree C. Ruge
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Zdroj: Scopus-Elsevier
Popis: A 24-year-old healthy multigravid patient developed postpartum hemorrhage 3 days post normal delivery. She underwent curettage × 3 followed by laparotomy and hysterectomy. Postoperatively she developed a subrectus hematoma that required laparotomy and drainage. Persistent bleeding per vaginum prompted a third laparotomy for internal iliac ligation, which could not be carried out due to massive retroperitoneal hematoma. She received multiple transfusions of blood and blood products. Her APTT was prolonged but DIC screen was negative. Prolonged APTT was not corrected by addition of normal plasma. This pointed to autoantibodies to factor VIII. She responded to immunosuppression with prednisolone and cyclophosphamide.
Databáze: OpenAIRE