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围产期获得性血友病A:诊断与治疗困境

Acquired Hemophilia A in Peripartum Period: Diagnostic and Therapeutic Dilemma.

作者信息

Bin Waqar Syed Hamza, Khoury Leen, Hussain Ather, McFarlane Isabel M

机构信息

Hematology and Oncology, SUNY Downstate Medical Center, New York, USA.

Hematology and Oncology, Rochester General Hospital, Rochester, USA.

出版信息

Cureus. 2021 Aug 1;13(8):e16803. doi: 10.7759/cureus.16803. eCollection 2021 Aug.

Abstract

Acquired hemophilia A (AHA) is a bleeding diathesis caused by auto-antibody generation against factor VIII, an essential component of the coagulation cascade. Although having many etiologies, pregnancy is also one of the conditions associated with AHA. It mostly presents as a raised activated partial thromboplastin time (aPTT), and during the peripartum and postpartum period, concern for AHA should be raised as delays in diagnosis can be detrimental. Herein, we present a case of a 31-year-old female with sickle cell trait who developed venous bleeding and, later, neuraxial, musculoskeletal, and subcutaneous bleeding. She underwent an extensive course of treatment before getting into remission.

摘要

获得性血友病A(AHA)是一种由于针对凝血级联反应的重要组成部分——凝血因子VIII产生自身抗体而导致的出血性素质。尽管病因众多,但妊娠也是与AHA相关的情况之一。它主要表现为活化部分凝血活酶时间(aPTT)升高,在围产期和产后期间,应提高对AHA的警惕,因为诊断延迟可能有害。在此,我们报告一例31岁具有镰状细胞性状的女性病例,该患者出现静脉出血,随后出现神经轴、肌肉骨骼和皮下出血。她在病情缓解前接受了广泛的治疗过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f56d/8406369/673dd4c3ae6c/cureus-0013-00000016803-i01.jpg

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