Madeley Jarrett, Hodges Georgina, Birchley Andrew
Department of Haematology, Cairns Hospital, Cairns, Queensland, Australia.
Department of Haematology, Townsville Hospital, Townsville, Queensland, Australia.
BMJ Case Rep. 2018 Oct 17;2018:bcr-2018-226588. doi: 10.1136/bcr-2018-226588.
This case illustrates a 36-year-old man who presented with a factor VIII (FVIII) inhibitor (acquired haemophilia A) with cutaneous bleeding and a significant thigh haematoma. No traditional risk factors for the development of a FVIII inhibitor were identified. However, previous treatment with alemtuzumab for multiple sclerosis was noted in the patient's history. Alemtuzumab is an anti-CD52 monoclonal antibody and is known to be associated with the development of a number of autoimmune conditions, with a delay in onset of these conditions as long as 5 years after the cessation of treatment. To our knowledge, there have only been three previously documented cases of a FVIII inhibitor in the setting of alemtuzumab therapy. This case adds further evidence to the current body of literature suggesting alemtuzumab as a causative agent for the development of an FVIII inhibitor.
该病例为一名36岁男性，表现为伴有皮肤出血和严重大腿血肿的VIII因子（FVIII）抑制物（获得性血友病A）。未发现导致FVIII抑制物形成的传统风险因素。然而，患者病史中记录有先前使用阿仑单抗治疗多发性硬化症。阿仑单抗是一种抗CD52单克隆抗体，已知与多种自身免疫性疾病的发生有关，这些疾病的发病延迟可长达治疗停止后5年。据我们所知，先前仅有3例记录在案的阿仑单抗治疗引发FVIII抑制物的病例。该病例为当前文献进一步提供了证据，表明阿仑单抗是导致FVIII抑制物形成的病因。
