Korean J Otorhinolaryngol-Head Neck Surg.  2015 Nov;58(11):781-785. 10.3342/kjorl-hns.2015.58.11.781.

Unexpected Bleeding Following Endoscopic Sinus Surgery Leading to the Rare Diagnosis of Acquired Haemophilia A

• Ahn SH
• Kim YW
• Im DH
• Kim JK

• KMID: 2129809
• DOI: http://doi.org/10.3342/kjorl-hns.2015.58.11.781

Abstract

We report a case of acquired hemophilia A following endoscopic sinus surgery. The patient was a 64-year-old man whose preoperative activated partial thromboplastin time (aPTT) was slightly prolonged. He underwent endoscopic sinus surgery for chronic rhinosinusitis with nasal polyp. Nasal bleeding occurred spontaneously on the postoperative day 3. The aPTT was prolonged at 58.9 s, with factor VIII activity of 21% and a positive factor VIII inhibitor. Treatment with factor VIII and methylprednisolone resulted in remission within 1 month. This is the first of such case reported in Korea; the patient was treated by recombinant factor VIII replacement and steroid therapy.

Keyword

Acquired hemophilia A; Endoscopic sinus surgery; Factor VIII; Factor VIII inhibitor; Steroid

MeSH Terms

Diagnosis*
Epistaxis
Factor VIII
Hemophilia A*
Hemorrhage*
Humans
Korea
Methylprednisolone
Middle Aged
Nasal Polyps
Partial Thromboplastin Time
Factor VIII
Methylprednisolone