Acquired Hemophilia A: A Permanent Challenge for All Physicians

Nowak, Karol; Carpinteiro, Alexander; Szalai, Cynthia; Saner, Fuat H.

doi:10.3390/medicines9030021

Cited by 7 publications

(7 citation statements)

References 28 publications

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“…AHA is a rare autoimmune disorder resulting from the production of autoantibodies against FVIII affecting mainly the elderly with an incidence of around 1.4 cases Fig. 1 Ecchymotic spot on the left flank of the abdomen reaching the left iliac crest per 1.000.000 [10] and leading to high morbidity and mortality especially if untreated. AHA should be suspected in front of an isolated prolonged a PTT with or without bleeding and confirmed by detecting a FVIII inhibitor [9].…”

Section: Discussionmentioning

confidence: 99%

Acquired hemophilia A following COVID-19 vaccine: a case report

et al. 2023

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Background In the literature, reported cases of Acquired hemophilia A (AHA) induced by COVID-19 vaccination occurred after Adenoviral Vector Deoxyribonucleic Acid (DNA)- and SARS-CoV-2 Messenger Ribonucleic acid (mRNA)-Based vaccines. Here, and to the best of our knowledge, we report the first case of AHA occurring after an inactivated Sinovac-coronavac COVID-19 vaccine. Case presentation A 69-year-old Tunisian male patient consulted for severe left leg pain limiting physical mobility due to a 5*6 cm large ecchymosis located at the left inner thigh, having spontaneously appeared 5 days prior consultation and without notion of trauma. The patient had no known personal medical history. He had received the second dose of CoronaVac-SinoVac vaccine 30 days prior to consultation. Further physical examination revealed the presence of two other ecchymoses: one at the inner face of the right forearm, starting at the wrist reaching the elbow and the other at the left flank of the abdomen. Diagnosis of AHA was based on clinical presentation and confirmed with prolonged a PTT, Factor VIII deficiency and the presence of an FVIII inhibitor. The patient was successfully treated with corticosteroids and low dose Rituximab. Conclusion Clinicians should consider AHA in front of prolonged aPTT with or without spontaneous bleedings even after inactivated virus COVID-19.

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Section: Discussionmentioning

confidence: 99%

Acquired hemophilia A following COVID-19 vaccine: a case report

et al. 2023

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“…The diagnosis and treatment are described as usually delayed. However, the cause of AHA is still unknown 1, 6 . In this case, the symptoms appeared on Day 5 after receipt of the Pfizer BioNTech COVID-19 vaccine, indicating their relation to the vaccination.…”

Section: Discussionmentioning

confidence: 99%

Acquired Hemophilia A Following a COVID-19 mRNA Vaccine: A Case Report

Daud,

Abdullah,

Azmie

et al. 2023

Biomed. Res. Ther.

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Background: Acquired hemophilia A (AHA) develops due to autoantibodies directed against factor VIII. It can occur spontaneously or be triggered by various factors. Here, we report a case of AHA induced by the Pfizer-BioNTech COVID-19 vaccine in an older patient. Case presentation: The patient presented with multiple spontaneous bruises after receiving the Pfizer-BioNTech COVID-19 vaccine. Laboratory investigations revealed an isolated prolonged activated partial thromboplastin time (APTT) with an uncorrected mixing test. The factor VIII level was found to be low (0.6%). Additionally, the Bethesda assay evidenced the presence of an inhibitor of factor VIII. The patient was administered IV methylprednisolone and recombinant factor VIII. Then, he was maintained with oral azathioprine and prednisolone. However, the patient's condition showed no significant improvement. Thus, rituximab was administered, to which the patient responded well. Discussion and conclusion: AHA is a rare adverse effect of the Pfizer-BioNTech COVID-19 vaccine. Although the exact mechanism underlying the development of this condition following vaccination against COVID-19 remains unclear, a diagnosis of AHA should be considered if a patient without a bleeding history presents with acute-onset bleeding and an isolated prolonged APTT.

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“…Patients with AHA exhibit the presence of an autoantibody directed against factor VIII, referred to as an inhibitor. Considering the compromised clotting ability in individuals with hemophilia, they face an elevated susceptibility to severe bleeding complications following surgical interventions or trauma (5). AHA predominantly manifests in two distinct age groups: young women during the postpartum period and elderly patients.…”

Section: Introductionmentioning

confidence: 99%

Acquired Hemophilia Successfully Treated with Recombinant Factor Ⅶa: A Case Report

Mahmoudiandehkordi,

Hadipour

2024

Preprint

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Acquired Hemophilia A (AHA) is a disorder characterized by the impaired clotting ability of the blood, primarily resulting from a deficiency in factor VIII, a crucial clotting protein. It is an infrequent disorder that affects a minority of individuals. This condition can pose a life-threatening risk, with reported mortality rates reaching as high as 22%. The diagnosis of AHA is challenging owing to its non-specific presentation and low prevalence rate. The primary objectives of treatment for AHA encompass the cessation and prevention of bleeding episodes, eradication of the inhibitor, and management of the underlying disease in secondary cases. This case report summarizes the successful treatment of a patient with AHA and major bleeding with the repeated use of prednisolone, recombinant factor VIIa, and rituximab.

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Acquired Hemophilia A: A Permanent Challenge for All Physicians

Cited by 7 publications

References 28 publications

Acquired hemophilia A following COVID-19 vaccine: a case report

Acquired hemophilia A following COVID-19 vaccine: a case report

Acquired Hemophilia A Following a COVID-19 mRNA Vaccine: A Case Report

Acquired Hemophilia Successfully Treated with Recombinant Factor Ⅶa: A Case Report

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