H-Index
14
Scimago Lab
powered by Scopus
eISSN: 2373-3586
call: +1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Logo

Medical Science Monitor Basic Research
MSM

Annals
ISI-Home

Cyclosporine Treatment in a Case of Acquired Hemophilia A Diagnosed After Tooth Extraction

Masakatsu Usui, Kenji Miki, Hiroshi Takeishi, Maeng Bong Jin, Shinsaku Imashuku

Department of Internal Medicine, Uji-Tokushukai Medical Center, Uji, Kioto, Japan

Med Sci Case Rep 2017; 4:24-27

DOI: 10.12659/MSCR.904123

Available online:

Published: 2017-04-04


#904123

BACKGROUND: Reports of acquired hemophilia A (AHA) at the time of tooth extraction in elderly patients are limited. Although current guidelines for the management of AHA recommend activated prothrombin complex concentrate (aPCC; FEIBA) or recombinant factor VIIa (rFVIIa) for hemostasis, followed by prednisolone and/or cyclophosphamide for the eradication of anti-factor VIII inhibitor, management of such patients differs case by case.
CASE REPORT: A 62-year-old Japanese female was found to have AHA with anti-FVIII inhibitor (11.9 BU/mL) when she developed bleeding after tooth extraction. In this case, we successfully managed hemostasis with fresh frozen plasma infusion/plasma exchange followed by a combination of cyclosporine A (CSA)/small dose prednisolone for inhibitor suppression.
CONCLUSIONS: Based on our experience and literature survey, we discussed the benefit/shortcoming of CSA in the management of AHA with high inhibitor titer (>5 BU/mL).

Keywords: Cyclosporine, Hemophilia A, Prednisolone, Shock, Hemorrhagic, Tooth Extraction



Back