THE APPEARANCE OF THE INHIBITORS TO FACTOR VIII IN AN ELDER PATIENT WITH MILD HAEMOPHILIA A
Abstract
Background. The inhibitors to F VIII are unusual in case of a mild haemophilia because the replacement therapy is seldom necessary. In case of severe trauma, when prolonged replacement therapy of F VIII is needed, the appearance of the inhibitors is more frequent. The mild form of the disease becomes a severe one and the haemorrhages are frequent.
Patient and methods. In case of our patient with mild form of haemophilia, the inhibitors to F VIII developed after prolonged replacement therapy for treatement of subdural haemorrhage. In the article we describe recurrent haemorrhages and treatement of them with FEIBA and rF VIIa.
Conclusions. Due to poor compliance of an elder patient we didn’t decide to treat the inhibitors for F VIII actively.
Downloads
References
Geraghty SJ BM, Haemophilia Nursing Alliance. Inhibitors: a complicating factor. Monograph, 1995.
Aledort L. Inhibitors in hemophilia patients: current status and management. Am J Hematol 1994; 47: 208–17.
Kasper CK. Treatment of factor VIII inhibitors. Prog Hemost Thromb 1989; 9: 57–86.
Kasper CK. Diagnosis and management of inhibitors to factors VIII and IX. An introductory discussion for physicians. Blood Ther Med 2002; 3: 4–20.
Lusher JM, Arkin S, Abildgaard CF, Schwartz RS. Kogenate Previously Untreated Study Group. Recombinant factor VIII for the treatment of previously untreated patients with hemophilia A. Safety, efficacy, and the developement of inhibitors. N Engl J Med 1993; 328: 453–9.
Penner JA, Kelly PE. Management of patients with factor VIII or IX inhibitors. Sem Thromb Hemost 1975; 1: 386–99.
Hoyer LW. Inhibitors in hemophilia. In: Forbes CD, Aledort L, Madhok R eds. Hemophilia. 1st ed. Oxford Chapman in Hall, 1997: 213–27.
Nilsson IM. Factor VIII/IX antibodies. In: Nilsson IM ed. Hemophilia. Stockholm: Pharmacia, 1994: 58–65.
Challenges in the treatment of haemophilia with inhibitors. Haemophilia 1999; Vol 5: Suppl 3: 1–9.
Lozier JN, Santagostino E, Kasper CK et al. Use of porcine factor VIII for surgical procedures in haemophilia A patients with inhibitors. Semin Hematol 1993; 30: 10–21.
Lusher JM, Blatt PM, Penner JA. Autoplex vs Proplex: a controled double blind study of effectivenes in acute hemarthrosis in hemophiliacs with inhibitors to factor VIII. Blood 1983; 62: 1135–8.
Hedner U, Glazer S, Falch J. Recombinant activated factor VII in the treatment of bleeding episodes in patients with inherited and acquired bleeding disorders. Transf Med Rev 1993, 7: 78–83.
Aledort LM. Unexpected bleeding disorders: identification, diagnosis and management. Hemophilia 2000; 6: 592–4.
The Author transfers to the Publisher (Zdravniški vestnik/Slovenian Medical Journal) all economic copyrights following form Article 22 of the Slovene Copyright and Related Rights Act (ZASP), including the right of reproduction, the right of distribution, the rental right, the right of public performance, the right of public transmission, the right of public communication by means of phonograms and videograms, the right of public presentation, the right of broadcasting, the right of rebroadcasting, the right of secondary broadcasting, the right of communication to the public, the right of transformation, the right of audiovisual adaptation and all other rights of the author according to ZASP.
The aforementioned rights are transferred non-exclusively, for an unlimited number of editions, for the term of the statutory
The Author can make use of his work himself or transfer subjective rights to others only after 3 months from date of first publishing in the journal Zdravniški vestnik/Slovenian Medical Journal.
The Publisher (Zdravniški vestnik/Slovenian Medical Journal) has the right to transfer the rights, acquired parties without explicit consent of the Author.
The Author consents that the Article be published under the Creative Commons BY-NC 4.0 (attribution-non-commercial) or comparable licence.