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Acquired hemophilia A in solid cancer: Two case reports and review of the literature

Acquired hemophilia A in solid cancer: Two case reports and review of the literature
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摘要 Acquired hemophilia A (AHA) is a rare, hemorrhagic autoimmune disease, whose pathogenesis involves reduced coagulation factor Ⅷ (FⅧ) activity related to the appearance of inhibitors against FⅧ. Common etiological factors include autoimmune diseases, ma-lignancy, and pregnancy. We report two cases of AHA in solid cancer. The first case is a 63-year-old man who developed peritoneal and intestinal bleeding after gastrectomy for gastric cancer. He was diagnosed with AHA, and was treated with prednisone, followed by cyclophosphamide. In the second case, a 68-year-old man developed a subcutaneous hemorrhage. He was diagnosed with AHA in hepatocellular carcinoma on CT imaging, and treated with rituximab alone. Hemostasis was achieved for both patients without bypassing agents as the amount of inhibitors was reduced and eradicated. However, both patients died within 1 yeardue to cancer progression. Successful treatment for AHA in solid cancer can be diffcult because treatment of the underlying malignancy is also required. Acquired hemophilia A(AHA) is a rare, hemorrhagic autoimmune disease, whose pathogenesis involves reduced coagulation factor Ⅷ(FⅧ) activity related to the appearance of inhibitors against FⅧ. Common etiological factors include autoimmune diseases, malignancy, and pregnancy. We report two cases of AHA in solid cancer. The first case is a 63-year-old man who developed peritoneal and intestinal bleeding after gastrectomy for gastric cancer. He was diagnosed with AHA, and was treated with prednisone, followed by cyclophosphamide. In the second case, a 68-year-old man developed a subcutaneous hemorrhage. He was diagnosed with AHA in hepatocellular carcinoma on CT imaging, and treated with rituximab alone. Hemostasis was achieved for both patients without bypassing agents as the amount of inhibitors was reduced and eradicated. However, both patients died within 1 year due to cancer progression. Successful treatment for AHA in solid cancer can be difficult because treatment of the underlying malignancy is also required.
作者 Makoto Saito Reiki Ogasawara Koh Izumiyama Akio Mori Takeshi Kondo Masanori Tanaka Masanobu Morioka Masahiro Ieko Makoto Saito;Reiki Ogasawara;Koh Izumiyama;Akio Mori;Takeshi Kondo;Masanori Tanaka;Masanobu Morioka;Masahiro Ieko(Department of Internal Medicine and Hematology, Aiiku Hospital;Department of Internal Medicine, Health Sciences University of Hokkaido)
出处 《World Journal of Clinical Cases》 SCIE 2018年第14期781-785,共5页 世界临床病例杂志
关键词 Acquired hemophilia A Coagulation factor Solid cancer Gastric cancer Hepatocellular carcinoma Case report 血友病 自身免疫性疾病 保健知识 健康
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