Letter to the Editor Pregnancy exacerbates complications of acquired hemophilia in a patient with systemic lupus erythematosus

Sebastian, Agata; Misterska-Skóra, Maria; Podolak-Dawidziak, Maria; Szmyrka, Magdalena; Sebastian, Maciej; Wiland, Piotr

doi:10.5114/pdia.2014.40964

Cited by 4 publications

(12 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…second choice therapy [20,35,39,45,48,50]; in all those reports, treatment ended with eradication of the inhibitory antibodies and disease control. Alternative immunosuppressive drugs were cyclosporine [29,30] and azathioprine [19,36,44], while intravenous immunoglobulin were used in association with cyclophosphamide or azathioprine in two patients and as monotherapy in just one, showing however no efficacy [23,40,44]. Table II shows the main characteristics of available papers concerning acquired hemophilia cases with rheumatoid arthritis.…”

Section: Resultsmentioning

confidence: 99%

“…In the SLE group, the connectivity diagnosis was concomitant with the AH one in 5 patients [19][20][21][22]29], suggesting a potential role of the disease activity on the inhibitory FVIII antibodies formation. The only systemic sclerosis patient developed AH after autologous hematopoietic stem cell transplantation [50].…”

Section: Case Reportmentioning

confidence: 99%

“…In our literature review, 11 patients required antihemorrhagic treatment, which consisted in: factor VIII concentrates, recombinant factor VIIa, FIX plasma concentrate, factor eight inhibitor bypassing activity (FEIBA), or activated prothrombin complex concentrates (aPCC) [20,21,23,25,29,30,35,37,38,40,50].…”

Section: Case Reportmentioning

confidence: 99%

“…We found 35 cases ( Figure 1): 15 in systemic lupus erythematosus (SLE) [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32], 12 in rheumatoid arthritis [28,[33][34][35][36][37][38][39][40][41][42][43], 4 in Sjögren's syndrome (SS) [44][45][46][47], 2 in polymyalgia rheumatica (PMR) [48,49], 1 in systemic sclerosis (SSc) [50], and 1 in psoriatic arthritis (PA) [51].…”

Section: Case Reportmentioning

confidence: 99%

“…The main clinical presentation was ecchymosis/cutaneous hematomas, (19 of 23, 82%) [19][20][21][22]24,25,28,29,[35][36][37][38]40,44,45,48,50,51] followed by muscular hematomas (10 of 23, 43%) [22,23,28,3 6,37,39,40,44,49,51], the latters mainly in the RA group (Table II). As expected, hemarthroses were quite rare in the literature, described in just two cases, one in RA and RA, since it is indicated in the treatment of RA [52].…”

Section: Case Reportmentioning

confidence: 99%

See 4 more Smart Citations

Acquired Hemophilia in a Patient With Rheumatoid Arthritis: Case Report and Literature Review

Jaber

Bortolotti

Martinelli

et al. 2019

CMI

View full text Add to dashboard Cite

Acquired hemophilia (AH) is a rare bleeding disorder caused by the spontaneous development of autoantibodies against coagulation factors, most commonly factor (F) VIII (acquired hemophilia A, AHA). The clinical manifestation of AHA includes mostly spontaneous hemorrhages into skin, mucous membranes, muscles, soft tissues, or joints. AHA should be suspected when a patient with no history of hemorrhages presents with bleeding and an unexplained prolonged activated partial thromboplastin time. The diagnosis is based on the clinical picture, the presence of low FVIII activity and evidence of FVIII inhibitor. In around half of patients, an underlying disorder (rheumatic diseases, malignancy, infections) or taking some drugs are associated with AHA; the remaining cases are idiopathic. Rheumatoid arthritis is a chronic inflammatory condition, marked by swelling and tenderness of small joints; it is usually treated with steroid and immunosuppressive drugs such as methotrexate, TNF-alpha inhibitors, and other biologic therapies (abatacept, tocilizumab, rituximab).We presented a patient with rheumatoid arthritis who developed acquired hemophilia A with hemarthroses; starting from this case, we focused on the literature about AHA in rheumatic diseases. We found 35 cases, 15 in systemic lupus erythematosus and 12 in rheumatoid arthritis, while the remaining cases were reported in Sjögren’s syndrome, polymyalgia rheumatica, systemic sclerosis, and psoriatic arthritis. Ecchymosis and cutaneous hematomas were the main clinical features while hemarthroses was quite a rare condition, shown in just three patients.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

See 3 more Smart Citations

Acquired Hemophilia in a Patient With Rheumatoid Arthritis: Case Report and Literature Review

Jaber

Bortolotti

Martinelli

et al. 2019

CMI

View full text Add to dashboard Cite

show abstract

Role of PTHrP nuclear localization and carboxyl terminus sequences in postnatal spinal cord development

Liu

Wang

et al. 2020

Developmental Neurobiology

View full text Add to dashboard Cite

Parathyroid hormone‐related peptide (PTHrP) acts under physiological conditions to regulate normal development of several tissues and organs. The role of PTHrP in spinal cord development has not been characterized. Pthrp knock in (Pthrp KI) mice were genetically modified to produce PTHrP in which there is a deficiency of the nuclear localization sequence (NLS) and C‐terminus. Using this genetically modified mouse model, we have characterized its effect on spinal cord development early postnatally. The spinal cords from Pthrp KI mice displayed a significant reduction in its length, weight, and cross‐sectional area compared to wild‐type controls. Histologically, there was a decreased development of neurons and glial cells that caused decreased cell proliferation and increased apoptosis. The neural stem cells (NSCs) cultures also revealed decreased cell proliferation and differentiation and increased apoptosis. The proposed mechanism of delayed spinal cord development in Pthrp KI mice may be due to alteration in associated pathways in regulation of cell‐division cycles and apoptosis. There was significant downregulation of Bmi‐1 and upregulation of cyclin‐dependent kinase inhibitors p27, p21, and p16 in Pthrp KI animals. We conclude that NLS and C‐terminus peptide segments of PTHrP play an important role in inhibiting cell apoptosis and stimulation of cellular proliferation necessary for normal spinal cord development.

show abstract

Acquired Factor VIII Deficiency Presenting as Gross Hematuria in a Hispanic, Pregnant Patient with Previously Undiagnosed Connective Tissue Disease

Loftis

Dulgheru

White

2021

Case Reports in Rheumatology

View full text Add to dashboard Cite

Acquired factor VIII deficiency is a bleeding disorder caused by the presence of autoantibodies against clotting factor VIII. We report a case of a 24-year-old pregnant woman who presented with gross hematuria secondary to acquired factor VIII deficiency in the presence of a previously undiagnosed connective tissue disease. This article includes a literature review of pregnancy-related cases of acquired factor VIII deficiency. We also reviewed various therapeutic approaches for the management of the acquired factor inhibitor which include achieving hemostasis and elimination of the inhibitor via immunosuppressive agents. This case report describes the rare presentation of acquired factor VIII deficiency related to pregnancy and highlights the importance of considering a factor VIII inhibitor in the differential diagnosis of patients who present with bleeding and prolonged PTT during the peripartum and postpartum periods.

show abstract

Letter to the Editor Pregnancy exacerbates complications of acquired hemophilia in a patient with systemic lupus erythematosus

Cited by 4 publications

References 10 publications

Acquired Hemophilia in a Patient With Rheumatoid Arthritis: Case Report and Literature Review

Acquired Hemophilia in a Patient With Rheumatoid Arthritis: Case Report and Literature Review

Role of PTHrP nuclear localization and carboxyl terminus sequences in postnatal spinal cord development

Acquired Factor VIII Deficiency Presenting as Gross Hematuria in a Hispanic, Pregnant Patient with Previously Undiagnosed Connective Tissue Disease

Contact Info

Product

Resources

About