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Challenging treatment for refractory acquired haemophilia A complicated with severe severe acute respiratory coronavirus 2 infection.
Blood Coagul Fibrinolysis ; 33(6): 342-347, 2022 Sep 01.
Article in English | MEDLINE | ID: covidwho-2001485
ABSTRACT
Immunosuppressive treatment and bypassing agents are used to treat acquired haemophilia A (AHA). On the other hand, COVID-19 infection induces a hypercoagulable state. Managing bleeding, risk of thrombosis, bypassing agents, active infection and immunosuppressive treatment can be challenging. A 72-year-old man was diagnosed with acquired hemophilia A. He received steroids, rituximab and recombinant activated factor VII (rFVIIa). He developed severe SARS-CoV-2 infection. Due to thrombotic risk, he received low-molecular-weight heparin (LMWH) and developed an iliopsoas hematoma. Because of the risk of thrombosis, treatment with recombinant porcine FVIII (rpFVIII) was requested. Tocilizumab was administered for treatment of SARS-CoV-2 infection and unexpected improvement of FVIII levels was noted. Concluding, rpFVIII treatment was well tolerated and effective, easy to monitor and to administer. Tocilizumab may play a role as immunosuppressive treatment for AHA. The role of LMWH remains to be established in patients with coagulopathies.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia / COVID-19 / COVID-19 Drug Treatment / Hemophilia A Type of study: Case report / Prognostic study Topics: Long Covid Limits: Animals / Humans / Male Language: English Journal: Blood Coagul Fibrinolysis Journal subject: Vascular Diseases / Hematology Year: 2022 Document Type: Article Affiliation country: MBC.0000000000001149

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia / COVID-19 / COVID-19 Drug Treatment / Hemophilia A Type of study: Case report / Prognostic study Topics: Long Covid Limits: Animals / Humans / Male Language: English Journal: Blood Coagul Fibrinolysis Journal subject: Vascular Diseases / Hematology Year: 2022 Document Type: Article Affiliation country: MBC.0000000000001149