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Life-threatening hemorrhage from acquired hemophilia A as a presenting manifestation of prostate cancer

Acquired factor VIII deficiency (acquired hemophilia A) is a rare condition characterized by the acquisition of autoantibodies that affect the clotting activity of factor VIII (fVIII). The most common manifestation in affected patients is a hemorrhagic diathesis. This disorder is associated with aut...

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Autores principales: Sheth, Chirag, Gill, Amandeep, Sekhon, Sumeet
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Co-Action Publishing 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5016740/
https://www.ncbi.nlm.nih.gov/pubmed/27609734
http://dx.doi.org/10.3402/jchimp.v6.32461
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author Sheth, Chirag
Gill, Amandeep
Sekhon, Sumeet
author_facet Sheth, Chirag
Gill, Amandeep
Sekhon, Sumeet
author_sort Sheth, Chirag
collection PubMed
description Acquired factor VIII deficiency (acquired hemophilia A) is a rare condition characterized by the acquisition of autoantibodies that affect the clotting activity of factor VIII (fVIII). The most common manifestation in affected patients is a hemorrhagic diathesis. This disorder is associated with autoimmune diseases, pregnancy, postpartum period, drugs, and malignancy. Management of this condition begins with attempts to arrest an acute bleed based on the site and severity of bleeding and inhibitor titer. The next priority is eradication of the fVIII antibodies using immunosuppressive therapies. We report the case of a 66-year-old male who presented with spontaneous right thigh hematoma with prolonged activated partial prothrombin time and normal prothrombin time. Mixing studies confirmed the presence of an inhibitor. Further investigation for the underlying etiology of acquired hemophilia A leads to diagnosis of prostate cancer. Treatment consisted of bypassing agents including activated factor VII and activated prothrombin plasma concentrate to arrest the bleeding. Steroids and cyclophosphamide were added to suppress the fVIII inhibitors. Concomitant treatment of locally advanced prostate cancer with chemotherapy confirmed the eradication of the inhibitors. To our knowledge, this is the first reported case of prostate cancer diagnosed and treated simultaneously with acquired hemophilia A resulting in favorable patient outcome.
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spelling pubmed-50167402016-09-26 Life-threatening hemorrhage from acquired hemophilia A as a presenting manifestation of prostate cancer Sheth, Chirag Gill, Amandeep Sekhon, Sumeet J Community Hosp Intern Med Perspect Case Report Acquired factor VIII deficiency (acquired hemophilia A) is a rare condition characterized by the acquisition of autoantibodies that affect the clotting activity of factor VIII (fVIII). The most common manifestation in affected patients is a hemorrhagic diathesis. This disorder is associated with autoimmune diseases, pregnancy, postpartum period, drugs, and malignancy. Management of this condition begins with attempts to arrest an acute bleed based on the site and severity of bleeding and inhibitor titer. The next priority is eradication of the fVIII antibodies using immunosuppressive therapies. We report the case of a 66-year-old male who presented with spontaneous right thigh hematoma with prolonged activated partial prothrombin time and normal prothrombin time. Mixing studies confirmed the presence of an inhibitor. Further investigation for the underlying etiology of acquired hemophilia A leads to diagnosis of prostate cancer. Treatment consisted of bypassing agents including activated factor VII and activated prothrombin plasma concentrate to arrest the bleeding. Steroids and cyclophosphamide were added to suppress the fVIII inhibitors. Concomitant treatment of locally advanced prostate cancer with chemotherapy confirmed the eradication of the inhibitors. To our knowledge, this is the first reported case of prostate cancer diagnosed and treated simultaneously with acquired hemophilia A resulting in favorable patient outcome. Co-Action Publishing 2016-09-07 /pmc/articles/PMC5016740/ /pubmed/27609734 http://dx.doi.org/10.3402/jchimp.v6.32461 Text en © 2016 Chirag Sheth et al. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Sheth, Chirag
Gill, Amandeep
Sekhon, Sumeet
Life-threatening hemorrhage from acquired hemophilia A as a presenting manifestation of prostate cancer
title Life-threatening hemorrhage from acquired hemophilia A as a presenting manifestation of prostate cancer
title_full Life-threatening hemorrhage from acquired hemophilia A as a presenting manifestation of prostate cancer
title_fullStr Life-threatening hemorrhage from acquired hemophilia A as a presenting manifestation of prostate cancer
title_full_unstemmed Life-threatening hemorrhage from acquired hemophilia A as a presenting manifestation of prostate cancer
title_short Life-threatening hemorrhage from acquired hemophilia A as a presenting manifestation of prostate cancer
title_sort life-threatening hemorrhage from acquired hemophilia a as a presenting manifestation of prostate cancer
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5016740/
https://www.ncbi.nlm.nih.gov/pubmed/27609734
http://dx.doi.org/10.3402/jchimp.v6.32461
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