Successful Outcome of Severe Intra-cerebral Bleeding Associated with Acquired Factor V Inhibition: Utilization of Multiple Therapeutic Agents.
Τίτλος | Successful Outcome of Severe Intra-cerebral Bleeding Associated with Acquired Factor V Inhibition: Utilization of Multiple Therapeutic Agents. |
Publication Type | Journal Article |
Year of Publication | 2018 |
Authors | Andreadis, P., Kafantari K., Agapidou A., Vakalopoulou S., & Vlachaki E. |
Journal | Balkan Med J |
Volume | 35 |
Issue | 1 |
Pagination | 112-115 |
Date Published | 2018 01 20 |
ISSN | 2146-3131 |
Λέξεις κλειδιά | Aged, Cerebral Hemorrhage, Cyclophosphamide, Factor V, Hemophilia A, Heparin, Low-Molecular-Weight, Humans, Male, Rituximab, Treatment Outcome |
Abstract | BACKGROUND: Acquired coagulation factor inhibitors are antibodies that either inhibit activity or increase the clearance of a clotting factor and lead to an increased risk of bleeding. Most of the time, the disorder is attributed to factor VIII inhibition (acquired haemophilia A); however, other coagulation factors could also be implicated.CASE REPORT: Herein, we report an interesting case of a patient who underwent coronary artery bypass grafting and received antibiotic treatment after surgery with third generation cephalosporin. A month later, he presented with extreme bleeding diathesis and cerebral haemorrhage. Following a thorough clinical and laboratory investigation, an acquired factor V inhibitor was diagnosed. The patient received treatment with corticosteroids, intravenous immunoglobulins, anti-CD20 monoclonal antibodies (rituximab), cyclophosphamide and recombinant factor VIIa. Finally, despite the poor initial prognosis, the patient managed to achieve a full recovery.CONCLUSION: As there are no clear guidelines on acquired coagulation inhibitor treatment, reports of such cases could offer insight for future therapy choices. The case was unique because the treatment regimen included a combination of multiple therapeutic agents including rituximab. |
DOI | 10.4274/balkanmedj.2017.0158 |
Alternate Journal | Balkan Med J |
PubMed ID | 28903884 |
PubMed Central ID | PMC5820439 |