TAILIEUCHUNG - Báo cáo y học: "Acquired hemophilia as the cause of lifethreatening hemorrhage in a 94-year-old man: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Acquired hemophilia as the cause of lifethreatening hemorrhage in a 94-year-old man: a case report. | Kelesidis et al. Journal of Medical Case Reports 2010 4 231 http content 4 1 231 jAg JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Acquired hemophilia as the cause of lifethreatening hemorrhage in a 94-year-old man a case report Theodoros Kelesidis Jonelle Raphael Elizabeth Blanchard Rekha Parameswaran Abstract Introduction Acquired factor VIII deficiency is a rare entity that can lead to severe and life-threatening bleeding. We describe a case of severe bleeding from the tongue secondary to acquired hemophilia and discuss treatment options including aminocaproic acid and recombinant factor VIII which have not been widely reported in the literature for the management of such patients. Case presentation A 94-year-old Caucasian man presented to our institution with diffuse bruising and extensive bleeding from the tongue secondary to mechanical trauma. He had no prior history of bleeding and his medical history was unremarkable except for dementia and hypertension. Coagulation studies revealed a prolonged activated partial thromboplastin time and a mixing study was consistent with the presence of an inhibitor. Quantitative assays revealed a reduced level of factor VIII activity 1 and the presence of a factor VIII inhibitor measured at seven Bethesda units in the serum. Oral prednisone therapy 60mg day was given. He also received intravenous aminocaproic acid and human concentrate of factor VIII Humate-P and topical anti-thrombolytic agents 100 units of topical thrombin cream . His hospital course was prolonged because of persistent bleeding and the development of profuse melena. He required eight units of packed red blood cells for transfusion. Hospitalization was also complicated by bradycardia of unclear etiology which started after infusion of aminocaproic acid. His activated partial thromboplastin time gradually normalized. He was discharged to a rehabilitation facility three weeks later with improving symptoms stable .

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