[Successful immunosuppressive therapy in female hemophilia A developing inhibitor after perioperative administration of factor VIII products].

Maki Yamaguchi, Yusuke Takaki, Yoshitaka Yamasaki, Shuki Oya, Takayuki Nakamura, Satoshi Morishige, Kazutoshi Aoyama, Fumihiko Mouri, Ryuta Takase, Yoko Matsuo, Koichi Osaki, Koji Nagafuji, Takashi Okamura
{"title":"[Successful immunosuppressive therapy in female hemophilia A developing inhibitor after perioperative administration of factor VIII products].","authors":"Maki Yamaguchi, Yusuke Takaki, Yoshitaka Yamasaki, Shuki Oya, Takayuki Nakamura, Satoshi Morishige, Kazutoshi Aoyama, Fumihiko Mouri, Ryuta Takase, Yoko Matsuo, Koichi Osaki, Koji Nagafuji, Takashi Okamura","doi":"10.11406/rinketsu.65.90","DOIUrl":null,"url":null,"abstract":"<p><p>A 62-year-old woman was diagnosed as a hemophilia A carrier (factor VIII activity 35%) on preoperative examination of an ovarian tumor. A total of 35,600 units of recombinant factor VIII products was administered perioperatively. On postoperative day 95, a subcutaneous hematoma formed and immunosuppressive therapy with prednisolone was started based on an APTT of 66 seconds, factor VIII (FVIII) activity of 3%, and FVIII inhibitor of 1 BU/ml. During this treatment, the patient was hospitalized due to ankle joint bleeds and required hemostatic treatment, but the inhibitor disappeared and FVIII activity recovered to 30% after postoperative day 438 with cyclophosphamide. F8 analysis revealed the patient carried a heterozygosity of p.Arg391Cys, which has previously been categorized as cross-reacting material (CRM)-positive severe hemophilia A. No high-risk mutations for inhibitor development were found. We also report the results of a desmopressin acetate hydrate test administered to the patient to prepare for future treatment in case of hemorrhage, since high-dose FVIII administration may have been a factor in inhibitor development.</p>","PeriodicalId":93844,"journal":{"name":"[Rinsho ketsueki] The Japanese journal of clinical hematology","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"[Rinsho ketsueki] The Japanese journal of clinical hematology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.11406/rinketsu.65.90","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

A 62-year-old woman was diagnosed as a hemophilia A carrier (factor VIII activity 35%) on preoperative examination of an ovarian tumor. A total of 35,600 units of recombinant factor VIII products was administered perioperatively. On postoperative day 95, a subcutaneous hematoma formed and immunosuppressive therapy with prednisolone was started based on an APTT of 66 seconds, factor VIII (FVIII) activity of 3%, and FVIII inhibitor of 1 BU/ml. During this treatment, the patient was hospitalized due to ankle joint bleeds and required hemostatic treatment, but the inhibitor disappeared and FVIII activity recovered to 30% after postoperative day 438 with cyclophosphamide. F8 analysis revealed the patient carried a heterozygosity of p.Arg391Cys, which has previously been categorized as cross-reacting material (CRM)-positive severe hemophilia A. No high-risk mutations for inhibitor development were found. We also report the results of a desmopressin acetate hydrate test administered to the patient to prepare for future treatment in case of hemorrhage, since high-dose FVIII administration may have been a factor in inhibitor development.

[女性 A 型血友病患者在围手术期使用 VIII 因子产品后出现抑制因子,成功接受免疫抑制治疗]。
一名 62 岁的妇女在卵巢肿瘤术前检查中被诊断为 A 型血友病携带者(VIII因子活性为 35%)。围手术期总共使用了 35,600 单位的重组因子 VIII 产品。术后第 95 天,皮下血肿形成,根据 APTT 为 66 秒、因子 VIII (FVIII) 活性为 3% 和 FVIII 抑制剂为 1 BU/ml,开始使用泼尼松龙进行免疫抑制治疗。治疗期间,患者因踝关节出血住院,需要止血治疗,但术后第 438 天服用环磷酰胺后,抑制剂消失,FVIII 活性恢复到 30%。F8 分析显示该患者携带 p.Arg391Cys 杂合子,该杂合子以前被归类为交叉反应物质(CRM)阳性重症 A 型血友病。我们还报告了对该患者进行醋酸去氨加压素水合物试验的结果,该试验的目的是为将来发生大出血时的治疗做准备,因为大剂量 FVIII 给药可能是抑制剂产生的一个因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信