Akira Matsumoto, Yoshiyuki Ogawa, Tsukasa Osaki, Masayoshi Souri, Hisashi Takei, Tetsuya Ishikawa, Nobuhiko Kobayashi, Yuri Miyazawa, Takuma Ishizaki, Madoka Inoue, Akitada Ichinose, Hiroshi Handa
During laparoscopic cholecystectomy, an 89-year-old man was discovered to have a prolonged APTT. He was transferred to our hospital for a thorough examination because wound bleeding necessitated a reoperation. Based on coagulation factor VIII activity (FVIII:C) of 3.6% and FVIII inhibitor levels of 48.5 BU/ml, he was diagnosed with acquired hemophilia A (AHA). Due to concerns about his advanced age and postoperative infection, immunosuppressive therapy with prednisolone 0.5 mg/kg/day was initiated. His clinical course was favorable, except hemorrhagic shock caused by intramuscular hemorrhage on the right back, although low FVIII inhibitor levels persisted for more than a month; additionally, lower leg edema and increased urinary protein were also observed...
2023: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology