[Successful cyclosporin therapy of acquired hemophilia caused by factor VIII (VIII:C) inhibiting antibody]. / VIII-as faktor (VIII:C) ellenes gátlótest okozta szerzett haemophilia sikeres kezelése cyclosporinnal.

A 47-year-old woman is reported who had a life-threatening, subarachnoideal bleeding due to the spontaneous development of factor VIII:C inhibitor. Cyclosporin combined with prednisone allowed a full recovery and the elimination of antibody even when other therapeutic facilities failed to be effective. Actual problems of treatment of factor VIII inhibitors are briefly surveyed.

[Fatal thrombotic microangiopathy in the mother and fetus]. / Az anya és a magzat halálához vezetö thrombotikus microangiopathia.

The appearance of thrombotic microangiopathy (thrombotic thrombocytopenic purpura, haemolytic uraemic syndrome) could have been documented in a 23 years old pregnant woman, who had been treated previously for immune-thrombocytolytic purpura. The disturbing anamnestic data caused significant delay in correct diagnosis and in starting of fresh-frozen plasma therapy, so the woman and her fetus (in utero) had been died. The specific histological microangiopathic lesions could have been well documented by the autopsy of the mother, however no such alterations could have been detected in the fetus and placenta. This latter intriguing observation might be remarkable in the evaluation of several concepts dealing with the aetiopathogenesis of thrombotic microangiopathy. The short review of literature of thrombotic microangiopathy in pregnancy and puerperial period is also given.

Cyclosporin treatment of a woman with acquired haemophilia due to factor VIII:C inhibitor.

A 47 year old woman is reported who had life-threatening bleeding due to the spontaneous development of factor VIII:C inhibitor. Cyclosporin combined with prednisone resulted in a full recovery and complete elimination of antibody even when other therapeutic facilities failed to be effective.

[Effect of hormonal contraceptives on the coagulation system with special reference to its inhibitors]. / A hormonális fogamzásgátlók hatása az alvadás-rendszerre, különös tekintettel annak néhány inhibitorára.

PIP: A controlled study of the antithrombin III (AT III), alpha2-macroglobulin (alpha2M), alphal-antitrypsin values of 71 long-term users of local oral contraceptives (OC) indicated that OCs are the most reliable contemporary anticontraceptive drugs, although thromboembolic side effects can be expected. The subjects were 16-35 years old and used Bisecurin, Ovidon, Rigevedon or Anteovin for 1-8 years. Thrombelastography (TEG) was performed to study the global coagulation process, and the 3 TEG parameters, reaction time (r), coagulation time (c), and maximum amplitude (A max) were calculated, yielding a hypercoagulation index. Prothrombin time (PT) and partial thromboplastin time (PTT) were also measured. Results showed a significant shortening of r values and slight decrease of c values in the OC users, as compared to the control (a 28-year old nonuser). The value of A max did not change much. Hypercoagulation was evident in all 3 groups, especially in Ovidon users. PT, PTT, and fibrinogen values did not change significantly. AT III:HC (heparin cofactor) values decreased 83% for Anteovin users, 91-96% for other OC users, but they did not drop to the critical 80% level. The alpha2M values became slightly elevated and alphalAT levels increased significantly in all except Anteovin users. These inhibitors of coagulation play an important role in hemostasis, and it is more likely that hypercoagulation is caused by the decreased level of inhibitors rather than the increase of coagulation factors. The significantly increased level of alpha1AT can pose a biochemical risk factor for thrombosis of veins, as it inhibits the fibrinolytic activity of granulocytes i.e., the formation of cellular fibrinolysis. Therefore, it is important to investigate the alpha1AT levels whenever AT III is normal in thrombosis.^ieng