A case of acquired hemophilia A diagnosed after percutaneous endoscopic gastrostomy

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• 作者：Takuma Okamura ; Michiharu Komatsu ; Akihiro Ito…
• 关键词：Acquired hemophilia A ; Factor VIII inhibitor ; Immunosuppression ; Percutaneous endoscopic gastrostomy ; Endoscopic therapy
• 刊名：Clinical Journal of Gastroenterology
• 出版年：2015
• 出版时间：October 2015
• 年：2015
• 卷：8
• 期：5
• 页码：290-293
• 全文大小：518 KB
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• 作者单位：Takuma Okamura (1)
  Michiharu Komatsu (1)
  Akihiro Ito (1)
  Tetsuya Ito (1)
  Tomoaki Suga (1)
  Norikazu Arakura (2)
  Hitoshi Sakai (3)
  Eiji Tanaka (1)
  
  1. Department of Gastroenterology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan
  2. Endoscopic Examination Center, Shinshu University Hospital, Matsumoto, Japan
  3. Department of Hematology, Shinshu University School of Medicine, Matsumoto, Japan
  
• 刊物主题：Gastroenterology; Hepatology; Abdominal Surgery; Colorectal Surgery; Surgical Oncology;
• 出版者：Springer Japan
• ISSN：1865-7265

文摘

A 65-year-old male with no personal or familial history of bleeding disorders underwent percutaneous endoscopic gastrostomy (PEG) for neurogenic dysphagia due to subarachnoid hemorrhage. On postoperative day 6, continuous oozing of venous blood was observed at the stoma. Prothrombin time was within normal range, but activated partial thromboplastin time was prolonged. Cross-mixing test results indicated the existence of an inhibitor, and laboratory findings revealed decreased factor VIII activity and high levels of factor VIII inhibitor. The patient was diagnosed as having acquired hemophilia A, for which steroid monotherapy was effective. Acquired hemophilia A is a rare but potentially fatal disease. Clinicians should be aware of this condition in patients presenting with sudden hemorrhage after PEG or other endoscopic treatments, even in those with no apparent history of bleeding. Keywords Acquired hemophilia A Factor VIII inhibitor Immunosuppression Percutaneous endoscopic gastrostomy Endoscopic therapy