Abstract Number: PB0445
Meeting: ISTH 2021 Congress
Theme: Hemophilia and Rare Bleeding Disorders » Acquired Hemorrhagic Coagulation Disorders
Background: Acquired hemophilia is a rare disease, classically severe in 80% of cases. The search for an associated pathological context is often negative; moreover, the postpartum represents 10% of the circumstances of discovery.
Aims: Clinical and etiological heterogeneity of acquired hemophilia.
Methods: We have collected all the clinical manifestations of the patients and the diagnostic assessment.
Results:
| Patient N°1 | Patient N°2 | Patient N°3 | Patient N°4 | Patient N°5 | |
| Age (years) /sex | 42 F | 27 F | 36 F | 18 F | 32 F |
| Evolution (months) | 2 | 4 | immediate post-partum | 8 | 8 arthralgia |
| History | Bronchial asthma G3P3 |
No history G1P1 |
No history G1P1 |
Aopecia PRP injection |
G5P3 2 abortion |
| Bleeding symptoms | Extensive ecchymosis | Extensive ecchymosis Gingivorrhagia Right Knee hemarthrosis |
Extensive ecchymosis Hematoma Hemoperitunium |
Muscle Hematoma Hemoperitineum |
Extensive ecchymosis |
| APTT (T) sec / rosner index | 59(31)/15 | 62(29)/16 | 81,5(30) | 73(31)/27,5 | 69(31)/27,4 |
| FVIII or IX | VIII: 0,5% | VIII<1% | VIII:1% | VIII:2% | IX: 23% VIII: 234% |
| Titer of inhibiteur UB | 19,2 | 83 | 32 | 54,8 | / |
Clinical manifestations and laboratory diagnosisPRP: platelet-rich plasma, F: Female
| Patient N°1 | Patient N°2 | Patient N°3 | Patient N°4 | Patient N°5 | |
| Etiology | Aquired post-partum hemophilia A | Acquired post-partum hemophilia A |
Acquired post-partum hemophilia A |
Alopecia lupus |
Acquired hemophilia B Sarcoidosis AHAI( TCD+) |
| Number of bleeding/episodes treated | 2/0 | 5/3 VIIr | 4/ 4 VIIr | 2/1 VIIr | 2/0 |
| Substantive treatment | Corticoisteroid | Corticoisteroid | Corticoisteroid /Anti-CD20 | Corticoisteroid | Corticoisteroid |
| Evolution | No bleeding NormaL APTT ACC(-) |
No bleeding NormaL APTT ACC(-) |
No bleeding NormaL APTT ACC(-) |
No bleeding NormaL APTT ACC(-) |
No bleeding Prolonged APTT (8 months) |
Etiology and managment of acquired hemophilia
Conclusions: Acquired postpartum hemophilia A represents the most frequent etiology in our series; the time to onset is very variable, ranging from the immediate postpartum up to 4 months. Despite its rarity, we diagnosed acquired hemophilia B from the postpartum period, the aetiological context found several immune disorders (autoimmune hemolytic anemia, sarcoidosis).the value of a multidisciplinary collaboration in its management and an adequate etiological treatment
To cite this abstract in AMA style:
Messaoudi R, SAIDI D, LAHMAR N, BELALDJ D, MOUADEN A, BENSAHLI M, DJAAFR M, TOUHAMI H. The Experience of Oran University Hospital in Algeria in the Management of Acquired Hemophilia [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/the-experience-of-oran-university-hospital-in-algeria-in-the-management-of-acquired-hemophilia/. Accessed November 29, 2023.« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/the-experience-of-oran-university-hospital-in-algeria-in-the-management-of-acquired-hemophilia/