Diagnosis and treatment of acquired haemophilia

Haemophilia. 2010 May;16(102):102-6. doi: 10.1111/j.1365-2516.2010.02232.x.

Abstract

Acquired haemophilia (AH) is an autoimmune syndrome characterized by acute bleeding in patients with negative family and personal history, and factor VIII depletion. Its incidence is 1.6 x 106 population per year. AH is associated with autoimmune diseases, solid tumours, lymphoprolipherative diseases, pregnancy; 50% of the cases idiopathic. Spontaneous or after minor trauma severe bleeding associated with a prolonged activated partial thromboplastin time, not corrected by incubation with normal plasma, with a normal prothrombin time are the diagnostic hallmarks. The goals of management are the control of bleeding and the suppression of inhibitor. First-line haemostatic treatment includes recombinant factor VIIa and activated prothrombin complex concentrate. Prednisone +/- cyclophosphamide and other immunosuppressive agents are the standard intervention for inhibitor eradication.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Coagulation Factor Inhibitors / analysis
  • Blood Coagulation Factors / administration & dosage
  • Blood Coagulation Factors / therapeutic use*
  • Factor VIII / administration & dosage
  • Factor VIII / therapeutic use*
  • Factor VIIa / administration & dosage
  • Factor VIIa / therapeutic use*
  • Female
  • Hemophilia A / diagnosis*
  • Hemophilia A / therapy*
  • Hemorrhage / prevention & control
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / therapeutic use*
  • Male
  • Middle Aged
  • Partial Thromboplastin Time
  • Recombinant Proteins / administration & dosage
  • Recombinant Proteins / therapeutic use

Substances

  • Blood Coagulation Factor Inhibitors
  • Blood Coagulation Factors
  • Immunosuppressive Agents
  • Recombinant Proteins
  • prothrombin complex concentrates
  • Factor VIII
  • recombinant FVIIa
  • Factor VIIa