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获得性血友病A合并大疱性类天疱疮的成功管理:一例报告及文献复习

Successful Management of Acquired Hemophilia A Associated with Bullous Pemphigoid: A Case Report and Review of the Literature.

作者信息

Binet Quentin, Lambert Catherine, Sacré Laurine, Eeckhoudt Stéphane, Hermans Cedric

机构信息

Hemostasis and Thrombosis Unit, Division of Hematology, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium.

Division of Dermatology, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium.

出版信息

Case Rep Hematol. 2017;2017:2057019. doi: 10.1155/2017/2057019. Epub 2017 Mar 28.

Abstract

. Acquired hemophilia A (AHA) is a rare condition, due to the spontaneous formation of neutralizing antibodies against endogenous factor VIII. About half the cases are associated with pregnancy, postpartum, autoimmune diseases, malignancies, or adverse drug reactions. Symptoms include severe and unexpected bleeding that may prove life-threatening. . We report a case of AHA associated with bullous pemphigoid (BP), a chronic, autoimmune, subepidermal, blistering skin disease. To our knowledge, this is the 25th documented case of such an association. Following treatment for less than 3 months consisting of methylprednisolone at decreasing dose levels along with four courses of rituximab (monoclonal antibody directed against the CD20 protein), AHA was completely cured and BP well-controlled. . This report illustrates a rare association of AHA and BP, supporting the possibility of eradicating the inhibitor with a well-conducted short-term treatment.

摘要

获得性血友病A(AHA)是一种罕见疾病,由于机体自发产生针对内源性凝血因子VIII的中和抗体所致。约半数病例与妊娠、产后、自身免疫性疾病、恶性肿瘤或药物不良反应有关。症状包括严重且意外的出血,可能危及生命。我们报告1例与大疱性类天疱疮(BP)相关的AHA病例,BP是一种慢性自身免疫性表皮下疱性皮肤病。据我们所知,这是第25例有文献记载的此类关联病例。在采用逐渐减量的甲泼尼龙治疗不到3个月并联合4个疗程的利妥昔单抗(一种针对CD20蛋白的单克隆抗体)治疗后,AHA完全治愈,BP得到良好控制。本报告阐述了AHA与BP之间的罕见关联,支持通过精心实施的短期治疗根除抑制物的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07c3/5387803/2002ec082855/CRIHEM2017-2057019.001.jpg

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