Hemorrhagic pericardial effusion as the debut of acquired hemophilia in a chronic lymphocytic leukemia patient
| Autor: | Cecilia Santos-Montón, María Teresa Cano-Mozo, Ana A. Martín, David González-Calle, José María Bastida, Pedro Pabón, Javier Carrillo, José Ramón González-Porras, Victor Eduardo Vallejo, Francisco Martín-Herrero, Soraya Merchán, Félix López-Cadenas, Jose Angel Torres-Hernández, Marcos González |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Pathology Cyclophosphamide Chronic lymphocytic leukemia medicine.medical_treatment Factor VIIa 030204 cardiovascular system & hematology Hemophilia A Pericardial effusion Antibodies Pericardial Effusion 03 medical and health sciences 0302 clinical medicine Prednisone hemic and lymphatic diseases medicine Humans Clinical Case Report Pericardiectomy Aged Blood coagulation test Factor VIII Coagulants business.industry Acquired hemophilia A Autoantibody General Medicine hemorrhagic pericardial effusion medicine.disease Leukemia Lymphocytic Chronic B-Cell Dermatology Recombinant Proteins Leukemia Treatment Outcome Echocardiography 030220 oncology & carcinogenesis chronic lymphocytic leukemia Radiography Thoracic Blood Coagulation Tests business Immunosuppressive Agents Research Article medicine.drug |
| Zdroj: | Medicine |
| ISSN: | 0025-7974 |
| DOI: | 10.1097/md.0000000000008669 |
| Popis: | Background: Acquired hemophilia A (AHA) is a rare bleeding disease caused by autoantibodies against factor VIII. Spontaneous bleeding symptoms usually affect the skin and muscle, while pericardial effusion is an extremely rare manifestation. In the elderly, anticoagulant treatment is frequent and bleeding symptoms are usually associated with this. Clinical findings: We report a hemorrhagic pericardial effusion as the AHA debut in a patient with untreated chronic lymphocytic leukemia and anticoagulated with apixaban for atrial fibrillation and chronic arterial ischemia. The patient was treated with recombinant activated factor VII to control the active bleeding and corticosteroids and cyclophosphamide to eradicate the inhibitor. In addition, a briefly review of hematological malignancies associated to acquired hemophilia was performed. Particularities: a) anticoagulant treatment may confuse the suspicion of AHA and its diagnosis; b) hemorrhagic pericardial effusion is an extremely rare presentation; c) bypassing agents raise the risk of thromboembolism; d) hematological malignancies rarely cause AHA ( |
| Databáze: | OpenAIRE |
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