两例获得性血友病A作为阿仑单抗治疗多发性硬化症并发症的病例报告。
Two case reports of acquired haemophilia A as complications of alemtuzumab treatment for multiple sclerosis.
作者信息
Gounder Kuhilan, Batt Tracey, Dreyer Michael
机构信息
Neurology, Royal Hobart Hospital, Hobart, Tasmania, Australia.
Haematology, Royal Hobart Hospital, Hobart, Tasmania, Australia.
出版信息
BMJ Neurol Open. 2021 Jan 18;3(1):e000095. doi: 10.1136/bmjno-2020-000095. eCollection 2021.
OBJECTIVE
To describe the case histories of two patients who developed acquired haemophilia A following treatment with alemtuzumab for multiple sclerosis.
RESULTS
Two patients, a 48-year-old woman and a 31-year-old woman, developed acquired haemophilia A 21 months after their second doses of alemtuzumab. Both presented with spontaneous bruising, and the second case reported menorrhagia. One patient required treatment to control bleeding. Both patients responded to treatment with prednisolone and cyclophosphamide to eliminate the inhibitor.
CONCLUSIONS
Acquired haemophilia A is a rare complication following treatment with alemtuzumab. Activated partial thromboplastin time and prothrombin time should be performed in cases of abnormal bleeding in which the platelet count is normal, to facilitate timely diagnosis and prevention of major bleeding complications.
目的
描述两名多发性硬化症患者在接受阿仑单抗治疗后发生获得性血友病A的病例史。
结果
两名患者，一名48岁女性和一名31岁女性，在第二次注射阿仑单抗21个月后发生获得性血友病A。两人均出现自发性瘀伤，第二例报告有月经过多。一名患者需要治疗以控制出血。两名患者均对泼尼松龙和环磷酰胺治疗有反应，以消除抑制剂。
结论
获得性血友病A是阿仑单抗治疗后的一种罕见并发症。在血小板计数正常的异常出血病例中，应进行活化部分凝血活酶时间和凝血酶原时间检测，以便及时诊断并预防严重出血并发症。
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