Related Experiment Videos
Surgery-associated acquired hemophilia A
G Theodossiades1, V Tsevrenis, E Nomikou
1First Regional Transfusion and Haemophilia Centre, Hippokration Hospital, Athens, Greece. blood@hellasnet.gr
Annals of Hematology
|January 5, 2002
Summary
Surgery can trigger acquired hemophilia, leading to factor VIII antibodies and severe bleeding post-operation. Early diagnosis and treatment with immunosuppression and hemostatic agents are crucial for successful outcomes.
Area of Science:
- Hematology
- Immunology
Background:
- Acquired hemophilia is a rare bleeding disorder characterized by the development of antibodies against coagulation factor VIII.
- Postoperative bleeding can have various causes, and acquired hemophilia may be an underrecognized complication.
Observation:
- Two patients developed factor VIII antibodies and severe hemorrhage in the immediate postoperative period.
- One patient on warfarin experienced delayed diagnosis due to initial misattribution of bleeding to elevated INR.
Findings:
- Abrupt onset of severe bleeding, prolonged activated partial thromboplastin time, low factor VIII levels, and detectable factor VIII antibodies were observed within days of surgery.
- Warfarin therapy complicated the diagnosis and management in one case.
Implications:
- Surgery should be considered a potential precipitating factor for acquired hemophilia, especially in cases of unusual postoperative bleeding.
- Prompt diagnosis and combined treatment strategies involving hemostatic control (e.g., recombinant activated FVII) and immunosuppression are vital for managing this condition.