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Acquired Hemophilia A Successfully Treated with Rituximab

Acquired hemophilia A (AHA) is a rare bleeding disorder due to the development of specific autoantibodies against factor VIII. The anti-CD20 monoclonal antibody Rituximab has been proven to be effective in obtaining a long-term suppression of inhibitors of AHA, besides other immunosuppressive standa...

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Autores principales: D’Arena, Giovanni, Grandone, Elvira, Di Minno, Matteo Nicola Dario, Musto, Pellegrino, Di Minno, Giovanni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Università Cattolica del Sacro Cuore 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4344169/
https://www.ncbi.nlm.nih.gov/pubmed/25745551
http://dx.doi.org/10.4084/MJHID.2015.024
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author D’Arena, Giovanni
Grandone, Elvira
Di Minno, Matteo Nicola Dario
Musto, Pellegrino
Di Minno, Giovanni
author_facet D’Arena, Giovanni
Grandone, Elvira
Di Minno, Matteo Nicola Dario
Musto, Pellegrino
Di Minno, Giovanni
author_sort D’Arena, Giovanni
collection PubMed
description Acquired hemophilia A (AHA) is a rare bleeding disorder due to the development of specific autoantibodies against factor VIII. The anti-CD20 monoclonal antibody Rituximab has been proven to be effective in obtaining a long-term suppression of inhibitors of AHA, besides other immunosuppressive standard treatments. Here we describe a case of idiopathic AHA in a 60-year old man successfully treated with rituximab. He showed a complete clinical response with a normalization of clotting parameters after 5 weekly courses of rituximab given at a dose of 375 mg/sqm., but after stopping rituximab, an initial worsening of coagulation parameters induced the addition of 3 further courses. At present, the patient is in complete clinical and hematological remission after 200 days. This case confirms that Rituximab may be a safe and useful tool to treat AHA and, a prolonged administration can overcome the initial resistance. However, the precise position of this drug in the therapeutic strategy (first or second-line, alone or in combination with other drugs) remains to be established and warrants further investigation.
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spelling pubmed-43441692015-03-05 Acquired Hemophilia A Successfully Treated with Rituximab D’Arena, Giovanni Grandone, Elvira Di Minno, Matteo Nicola Dario Musto, Pellegrino Di Minno, Giovanni Mediterr J Hematol Infect Dis Case Report Acquired hemophilia A (AHA) is a rare bleeding disorder due to the development of specific autoantibodies against factor VIII. The anti-CD20 monoclonal antibody Rituximab has been proven to be effective in obtaining a long-term suppression of inhibitors of AHA, besides other immunosuppressive standard treatments. Here we describe a case of idiopathic AHA in a 60-year old man successfully treated with rituximab. He showed a complete clinical response with a normalization of clotting parameters after 5 weekly courses of rituximab given at a dose of 375 mg/sqm., but after stopping rituximab, an initial worsening of coagulation parameters induced the addition of 3 further courses. At present, the patient is in complete clinical and hematological remission after 200 days. This case confirms that Rituximab may be a safe and useful tool to treat AHA and, a prolonged administration can overcome the initial resistance. However, the precise position of this drug in the therapeutic strategy (first or second-line, alone or in combination with other drugs) remains to be established and warrants further investigation. Università Cattolica del Sacro Cuore 2015-03-01 /pmc/articles/PMC4344169/ /pubmed/25745551 http://dx.doi.org/10.4084/MJHID.2015.024 Text en This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
D’Arena, Giovanni
Grandone, Elvira
Di Minno, Matteo Nicola Dario
Musto, Pellegrino
Di Minno, Giovanni
Acquired Hemophilia A Successfully Treated with Rituximab
title Acquired Hemophilia A Successfully Treated with Rituximab
title_full Acquired Hemophilia A Successfully Treated with Rituximab
title_fullStr Acquired Hemophilia A Successfully Treated with Rituximab
title_full_unstemmed Acquired Hemophilia A Successfully Treated with Rituximab
title_short Acquired Hemophilia A Successfully Treated with Rituximab
title_sort acquired hemophilia a successfully treated with rituximab
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4344169/
https://www.ncbi.nlm.nih.gov/pubmed/25745551
http://dx.doi.org/10.4084/MJHID.2015.024
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