TY - JOUR
T1 - An acquired factor VIII inhibitor responsive to high-dose gamma globulin
AU - Green, D.
AU - Kwaan, H. C.
PY - 1987
Y1 - 1987
N2 - A 55-year-old previously well woman noted easy bruising and developed a swollen, painful leg after minimal trauma. A compartment syndrome was diagnosed, and medial and lateral fasciotomies were performed with evacutation of a massive hematoma. However, blood rapidly reaccumulated in the wound. The VIII:C level was 2%, and 4 Bethesda units of factor VIII inhibitor were detected. After initial treatment with clotting factor concentrates and corticosteroids failed to control bleeding or reduce inhibitor titers, gamma globulin, 25 g dily for 5 days, was administered. The inhibitor became undetectable, VIII:C levels rose, and bleeding stopped. However, 5 days later VIII:C levels were again low and bleeding recurred. A second course of gamma globulin, 50 g daily for 2 days, was accompanied by a prompt increase in VIII:C, and uneventful recovery. In conclusion, in this patient with an autoantibody to VIII:C, a response to gamma globulin was observed on two occasions, and the second response came when steroids were being tapered and the patient was on no other medication.
AB - A 55-year-old previously well woman noted easy bruising and developed a swollen, painful leg after minimal trauma. A compartment syndrome was diagnosed, and medial and lateral fasciotomies were performed with evacutation of a massive hematoma. However, blood rapidly reaccumulated in the wound. The VIII:C level was 2%, and 4 Bethesda units of factor VIII inhibitor were detected. After initial treatment with clotting factor concentrates and corticosteroids failed to control bleeding or reduce inhibitor titers, gamma globulin, 25 g dily for 5 days, was administered. The inhibitor became undetectable, VIII:C levels rose, and bleeding stopped. However, 5 days later VIII:C levels were again low and bleeding recurred. A second course of gamma globulin, 50 g daily for 2 days, was accompanied by a prompt increase in VIII:C, and uneventful recovery. In conclusion, in this patient with an autoantibody to VIII:C, a response to gamma globulin was observed on two occasions, and the second response came when steroids were being tapered and the patient was on no other medication.
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U2 - 10.1055/s-0038-1646035
DO - 10.1055/s-0038-1646035
M3 - Article
C2 - 2451304
AN - SCOPUS:0023638433
SN - 0340-6245
VL - 58
SP - 1005
EP - 1007
JO - Thrombosis and Haemostasis
JF - Thrombosis and Haemostasis
IS - 4
ER -