Related Experiment Videos
[Autoantibodies and anti-factor VIII and Chlamydia pneumoniae infection]
L Da Mata1, M Costecalde, J François
1Département d'anesthésie-réanimation chirurgicale II, hôpital Claude-Huriez, rue Michel Polonowski, CHRU de Lille, 59037 Lille, France.
Abstract:
We report the case of a 64-year-old man without hemorrhagic history experiencing epistaxis. The standard hemostasis assessment including prothrombin index, activated partial thromboplastin time (APTT) and platelet count found an isolated abnormal APTT (105 sec vs 33 sec). Therefore, coagulation factors were explored. An acquired factor VIII deficiency (5%) with anti-FVIII antibody (4.5 Bethesda unit.mL-1) was recognised. This anti-FVIII antibody was related to a Chlamydia pneumoniae pulmonary infection. Treatment consisted of: i) Four successive anterior packing and activated factor VII infusion (Novoseven); ii) steroids injection and bi-antibiotherapy. The time course of the epistaxis was favourable under treatment.
Insights
A 64-year-old man with epistaxis was diagnosed with acquired factor VIII deficiency due to a Chlamydia pneumoniae infection. Treatment with factor VII infusion, steroids, and antibiotics resolved the bleeding.
Area of Science:
- Hematology
- Infectious Diseases
- Internal Medicine
Background:
- Epistaxis can be a symptom of underlying coagulation disorders.
- Acquired factor deficiencies are rare but can present with significant bleeding.
- Chlamydia pneumoniae infections are typically respiratory but can have systemic effects.
Observation:
- A 64-year-old male presented with recurrent epistaxis.
- Standard hemostasis tests revealed an isolated prolonged activated partial thromboplastin time (aPTT).
- Further investigation identified acquired factor VIII deficiency with a specific inhibitor.
Findings:
- The patient had severely reduced factor VIII activity (5%) and a detectable anti-FVIII antibody.
- The anti-FVIII antibody was linked to a concurrent Chlamydia pneumoniae pulmonary infection.
- Treatment involved anterior packing, activated factor VII concentrate (Novoseven), corticosteroids, and antibiotics.
Implications:
- This case highlights the potential link between Chlamydia pneumoniae infection and acquired factor VIII deficiency.
- Early diagnosis and multi-modal treatment are crucial for managing such rare bleeding disorders.
- Understanding this association can improve diagnostic and therapeutic strategies for patients with unexplained bleeding and infections.