Mingot-Castellano Maria Eva, Núñez Ramiro, Rodríguez-Martorell Francisco Javier
Unidad de Gestión Clínica Intercentros de Hematología, Hospital Regional Universitario de Málaga, Málaga, España.
Unidad de Gestión Clínica Intercentros de Hematología, Hospital Universitario Virgen Macarena y Hospital Universitario Virgen del Rocío, IBIS, Sevilla, España.
Med Clin (Barc). 2017 Apr 7;148(7):314-322. doi: 10.1016/j.medcli.2016.11.030. Epub 2017 Jan 22.
The development of circulating autoantibodies able to inhibit some coagulation proteins induces severe or even life-threatening bleeding. This disorder is called acquired haemophilia. This is a rare disease, although its impact may be underestimated because of the lack of records, the lack of knowledge by many specialists, the complexity of the laboratory diagnosis and, finally, because of the fulminant clinical presentation that often precludes diagnosis. Several studies established that mortality ranges between 9 and 33%. Not only haematologists but all physicians should be trained to follow the right steps to diagnose these patients as soon as possible in order to reduce such mortality rates. This review approaches the basic concepts dealing with the diagnosis and management of these patients and intends to assist physicians in identifying patients under suspicion of acquired haemophilia to correctly manage them and refer them to the appropriate Haemostasis Unit.
能够抑制某些凝血蛋白的循环自身抗体的产生会引发严重甚至危及生命的出血。这种病症被称为获得性血友病。这是一种罕见疾病,不过其影响可能因记录缺失、许多专科医生缺乏认识、实验室诊断复杂,以及最终因常常妨碍诊断的暴发性临床表现而被低估。多项研究表明死亡率在9%至33%之间。不仅血液科医生,所有医生都应接受培训,以便遵循正确步骤尽快诊断这些患者,从而降低此类死亡率。本综述探讨了与这些患者的诊断和管理相关的基本概念,旨在帮助医生识别疑似获得性血友病的患者,以便正确管理他们并将他们转诊至合适的止血科室。