{"title":"Acquired hemophilia A treated with rituximab in a 62-year-old female with rheumatoid arthritis: a case-based review.","authors":"D Mohamadzadeh, S Assar, F Farsad","doi":"10.4081/reumatismo.2023.1585","DOIUrl":null,"url":null,"abstract":"<p><p>Acquired hemophilia A (AHA) is a rare autoimmune disorder with unpredictable hemostasis that is caused by autoantibody formation against coagulation factor VIII. AHA can occur in the context of autoimmune inflammatory rheumatic disorders. Here we report the case of a 62-year-old female with an 11-year history of rheumatoid arthritis (RA) who presented with cutaneous and mucosal bleeding. Activated partial thromboplastin time was prolonged and not corrected by the mixing test. Factor VIII activity was decreased, and the anti-factor VIII antibody was positive. AHA associated with RA was diagnosed. The patient was treated with rituximab 500 mg weekly for 4 doses and prednisolone 10 mg/daily. The patient did not experience bleeding events after treatment, and factor VIII activity and inhibitor normalized. At the end of the article, we discuss similar cases of RA-associated AHA.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":null,"pages":null},"PeriodicalIF":1.2000,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Reumatismo","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4081/reumatismo.2023.1585","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Acquired hemophilia A (AHA) is a rare autoimmune disorder with unpredictable hemostasis that is caused by autoantibody formation against coagulation factor VIII. AHA can occur in the context of autoimmune inflammatory rheumatic disorders. Here we report the case of a 62-year-old female with an 11-year history of rheumatoid arthritis (RA) who presented with cutaneous and mucosal bleeding. Activated partial thromboplastin time was prolonged and not corrected by the mixing test. Factor VIII activity was decreased, and the anti-factor VIII antibody was positive. AHA associated with RA was diagnosed. The patient was treated with rituximab 500 mg weekly for 4 doses and prednisolone 10 mg/daily. The patient did not experience bleeding events after treatment, and factor VIII activity and inhibitor normalized. At the end of the article, we discuss similar cases of RA-associated AHA.
获得性血友病 A（AHA）是一种罕见的自身免疫性疾病，它是由针对凝血因子 VIII 的自身抗体形成引起的，具有不可预测的止血功能。AHA 可在自身免疫性炎症性风湿病的背景下发生。在此，我们报告了一例 62 岁女性患者的病例，她有 11 年的类风湿性关节炎（RA）病史，并出现皮肤和粘膜出血。活化部分凝血活酶时间延长，且无法通过混合试验得到纠正。因子 VIII 活性降低，抗因子 VIII 抗体呈阳性。确诊为与 RA 相关的 AHA。患者接受了利妥昔单抗治疗，每周 500 毫克，共 4 次，泼尼松龙 10 毫克/天。治疗后，患者未发生出血事件，因子 VIII 活性和抑制因子恢复正常。在文章的最后，我们将讨论类似的 RA 相关 AHA 病例。
期刊介绍：
Reumatismo is the official Journal of the Italian Society of Rheumatology (SIR). It publishes Abstracts and Proceedings of Italian Congresses and original papers concerning rheumatology. Reumatismo is published quarterly and is sent free of charge to the Members of the SIR who regularly pay the annual fee. Those who are not Members of the SIR as well as Corporations and Institutions may also subscribe to the Journal.
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