Korean J Hematol.  2009 Sep;44(3):163-167. 10.5045/kjh.2009.44.3.163.

Post-operative Bleeding due to Acquired Hemophilia Successfully Treated with Recombinant Factor VIIa: Case Report

• Lee N
• Yoon SH
• Lim W
• Kim MH
• Kim HJ
• Kim SK
• Park JS
• Seol YM
• Song MK
• Choi YJ
• Chung JS
• Cho GJ

• KMID: 2252136
• DOI: http://doi.org/10.5045/kjh.2009.44.3.163

Abstract

Acquired hemophilia is a rare but potentially life-threatening hemorrhagic disorder caused by the development of autoantibodies against coagulation factor VIII. Concentrates of human factor VIII, desmopressin, activated prothrombin complex concentrates, recombinant activated factor VII can all be used to control episodes of acute bleeding. The recent availability of bypassing agents like recombinant activated factor VII has been shown to be clinically safe and effective as treatment for acute bleeding. In this case report, a 67 year-old male patient with Rh negative blood type developed gross hematuria and bleeding after transurethral resection due to prostatic hypertrophy. After vesicocutaneous fistular reduction operation, post-operative bleeding was presented. The acute bleeding was controlled successfully by the combined treatment with recombinant activated factor VII (Novo seven(R)) and prednisone.

Keyword

Acquired hemophilia; Recombinant activated factor VII; Acute bleeding

MeSH Terms

Autoantibodies
Blood Coagulation Factors
Deamino Arginine Vasopressin
Factor VIIa
Factor VIII
Hematuria
Hemophilia A
Hemorrhage
Hemorrhagic Disorders
Humans
Male
Prostatic Hyperplasia
Prothrombin
Autoantibodies
Blood Coagulation Factors
Deamino Arginine Vasopressin
Factor VIII
Factor VIIa
Prothrombin

Figure

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  Fig. 1. Computed tomographic findings. (A) Hematoma in the left perirenal space with active bleeding at the posterior aspect of left kidney. (B) Hematoma in the pelvic extraperitoneal space.

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  Fig. 2. The change of aPTT in patient treated with recombinant activated Factor VII, Factor VIII, prednisone. After recombinant activated Factor VII was administered, aPTT decreased to normal range.

Reference

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