J Korean Med Sci.  2008 Feb;23(1):138-141. 10.3346/jkms.2008.23.1.138.

Transient Acquired Hemophilia Associated with Mycoplasma Pneumoniae Pneumonia

• Kim MS
• Kilgore PE
• Kang JS
• Kim SY
• Lee DY
• Kim JS
• Hwang PH

• KMID: 1786861
• DOI: http://doi.org/10.3346/jkms.2008.23.1.138

Abstract

Acquired hemophilia is a rare disorder caused by autoantibodies to factor VIII (FVIII) (also referred to as factor VIII inhibitors or anti-FVIII) and may be associated with pregnancy, underlying malignancy, or autoimmune disorders. A 33-month-old girl who presented with hematochezia and ecchymotic skin lesions was diagnosed with Mycoplasma pneumoniae pneumonia by serology and polymerase chain reaction. Hematologic studies showed a prolonged activated partial thromboplastin time (aPTT), partially corrected mixing test for aPTT, reduced levels of FVIII, and the presence of antibodies against FVIII. She was treated conservatively with prednisone and intravenous immunoglobulin (IVIG) without FVIII transfusion and recovered without sequelae. This report provides the first description of acquired hemophilia due to anti-FVIII in association with M. pneumoniae in Korea. We discuss this case in the context of the current literature on acquired hemophilia in children.

Keyword

Acquired Hemophilia; Anti-FVIII; Factor VIII inhibitor; Mycoplasma Pneumoniae Pneumonia; Autoantibodies

MeSH Terms

Autoantibodies/blood
Child, Preschool
Factor VIII/immunology
Female
Hemophilia A/*etiology
Humans
Partial Thromboplastin Time
Pneumonia, Mycoplasma/*complications/immunology
Time Factors

Figure

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  Fig. 1 Detection of Mycoplasma pneumoniae DNA amplification in a patient throat swab specimen by polymerase chain reaction.

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  Fig. 2 Radiologic finding on admission. Chest radiograph shows consolidation in left lower lung field and blunting of the costophrenic angle.

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  Fig. 3 The changes of aPTT, FVIII, factor VIII inhibitor during treatment. aPTT, activated partial thromboplastin time; F VIII, factor VIII; F VIII-I, factor VIII inhibitor; IVIG, intravenous immunoglobulin; AMA, anti-mycoplasma antibody.

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