An 80-year-old man with no personal or family history of bleeding, presented to hospital with extensive haematomas and skin bruising after using doxycycline. His basic lab workup was concerning for a coagulopathy with an elevated activated partial thromboplastin time and significant anaemia. Mixing studies and other factor levels were tested that led to the diagnosis of acquired haemophilia A with low factor VIII levels and high factor VIII antibodies. He was started on steroids, but his haemoglobin level continued to drop. Later, during his treatment, he was given multiple therapeutic agents, including cyclophosphamide, rituximab and recombinant factor VII (NovoSeven-R). Gradually factor VIII levels increased and haemoglobin stabilised. The hospital course was complicated by COVID-19 pneumonia leading to acute respiratory distress syndrome; the patient eventually expired due to respiratory failure.
机构:
Univ Utah, Sch Med, Pathol, Salt Lake City, UT 84112 USA
ARUP Labs, Anat Pathol, Salt Lake City, UT 84108 USAUniv Utah, Sch Med, Pathol, Salt Lake City, UT 84112 USA
Samowitz, Wade
Boynton, Kathleen
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机构:
Univ Utah, Div Gastroenterol, Hlth Sci Ctr, Internal Med,Sch Med,Gastroenterol, Salt Lake City, UT 84132 USAUniv Utah, Sch Med, Pathol, Salt Lake City, UT 84112 USA
Boynton, Kathleen
Kelly, Erinn Downs
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Univ Utah, Sch Med, Pathol, Salt Lake City, UT 84112 USA
Univ Utah, Hlth Sci Ctr, Huntsman Canc Hosp, ARUP Labs, Salt Lake City, UT USAUniv Utah, Sch Med, Pathol, Salt Lake City, UT 84112 USA