Division of Chest Surgery, Department of Surgery, Toho University School of Medicine, Tokyo, Japan.
Department of Surgical Pathology, Toho University School of Medicine, Tokyo, Japan.
Ann Thorac Cardiovasc Surg. 2022 Aug 20;28(4):302-306. doi: 10.5761/atcs.cr.20-00257. Epub 2021 Jan 20.
A 74-year-old man was admitted with lung cancer, and preoperative blood test showed abnormal activated partial thromboplastin time (APTT). Coagulation factor screening and APTT mixing test achieved a diagnosis of acquired hemophilia A (AHA). Bypassing agent therapy was indicated and lobectomy was successfully performed without bleeding complications. APTT returned to normal after the operation without any additional treatment for AHA. The pathogenesis of AHA is still unknown and there is no evidence for hemostatic strategy for AHA patients requiring surgery. This study supports the importance of hemostatic therapy and suggests that malignancy might cause AHA.
一位 74 岁男性因肺癌入院，术前血液检查显示活化部分凝血活酶时间（APTT）异常。凝血因子筛查和 APTT 混合试验明确诊断为获得性血友病 A（AHA）。需要使用旁路剂治疗，患者成功接受了肺叶切除术，没有出血并发症。术后 APTT 恢复正常，无需额外治疗 AHA。AHA 的发病机制尚不清楚，也没有证据表明需要手术的 AHA 患者的止血策略。本研究支持止血治疗的重要性，并提示恶性肿瘤可能导致 AHA。
