Recombinant factor VIIa for intracranial haemorrhage in a Jehovah's Witness with severe haemophilia A and factor VIII inhibitors.

A Jehovah's Witness with severe haemophilia A and a high titre, high responding inhibitor to both human and porcine factor VIII (FVIII) was treated with recombinant activated factor VII (rVIIa) during an episode of intracranial bleeding. He recovered completely without any adverse effects or neurological sequelae. Treatment with rVIIa in this case was safe and effective. This therapeutic agent should be considered in haemophilia patients with inhibitors who refuse management with blood products on religious grounds and when recombinant factor VIII is not a cost-effective option.