Skip to main content
Top
Published in: Indian Journal of Hematology and Blood Transfusion 3/2018

01-07-2018 | Original Article

Acquired Hemophilia A: Experience of a Tertiary Care Institute from North India

Authors: Narender Kumar, Sweta Rajpal, Jasmina Ahluwalia, Sunil Bose, Varun Uppal, Neelam Varma, Pankaj Malhotra, Subhash Varma

Published in: Indian Journal of Hematology and Blood Transfusion | Issue 3/2018

Login to get access

Abstract

Acquired hemophilia A (AHA) is an uncommon bleeding disorder infrequently reported among Indians. The present retrospective data comprises eight cases of AHA over a period of 15 years. The mean age of patients was 59.7 years. The activated partial thromboplastin time was prolonged in all cases and the inhibitor screen showed the presence of inhibitors. Factor VIII: C assay was performed in 7 cases and all cases demonstrated low levels. Lupus anticoagulant was negative. Six patients were managed with steroids and symptomatic supportive care. These patients were followed up for a mean period of 3.5 years (range 1–5 years). Of these, there was one fatality prior to initiation of therapy and one patient continues to have inhibitors.
Literature
1.
go back to reference Collins P, Hirsch S, Baglin TP, Dolan G, Hanley J, Makris M et al (2007) Acquired hemophilia A in the United Kingdom: a 2-year national surveillance study by the United Kingdom hemophilia centre doctors’ organisation. Blood 109:1870–1877CrossRefPubMed Collins P, Hirsch S, Baglin TP, Dolan G, Hanley J, Makris M et al (2007) Acquired hemophilia A in the United Kingdom: a 2-year national surveillance study by the United Kingdom hemophilia centre doctors’ organisation. Blood 109:1870–1877CrossRefPubMed
2.
go back to reference Collins P, Baudo F, Huth-Kühne A, Ingerslev J, Kessler CM, Castellano ME et al (2010) Consensus recommendations for the diagnosis and treatment of acquired hemophilia A. BMC Res Notes 3:161CrossRefPubMedPubMedCentral Collins P, Baudo F, Huth-Kühne A, Ingerslev J, Kessler CM, Castellano ME et al (2010) Consensus recommendations for the diagnosis and treatment of acquired hemophilia A. BMC Res Notes 3:161CrossRefPubMedPubMedCentral
3.
go back to reference Collins P, Budde U, Rand JH, Federici AB, Kessler CM (2008) Epidemiology and general guidelines of the management of acquired haemophilia and von Willebrand syndrome. Haemophilia 14:49–55CrossRefPubMed Collins P, Budde U, Rand JH, Federici AB, Kessler CM (2008) Epidemiology and general guidelines of the management of acquired haemophilia and von Willebrand syndrome. Haemophilia 14:49–55CrossRefPubMed
4.
go back to reference Knoebl P, Marco P, Baudo F, Collins P, Huth-Kuhne A, Nemes L et al (2012) Demographic and clinical data in acquired hemophilia A: results from the European Acquired Haemophilia Registry (EACH2). J Thromb Haemost 10:622–631CrossRefPubMed Knoebl P, Marco P, Baudo F, Collins P, Huth-Kuhne A, Nemes L et al (2012) Demographic and clinical data in acquired hemophilia A: results from the European Acquired Haemophilia Registry (EACH2). J Thromb Haemost 10:622–631CrossRefPubMed
6.
go back to reference Huth-Kuhne A, Baudo F, Collins P, Ingerslev J, Kessler CM, Lévesque H et al (2009) International recommendations on the diagnosis and treatment of patients with acquired hemophilia A. Haematologica 94:566–575CrossRefPubMedPubMedCentral Huth-Kuhne A, Baudo F, Collins P, Ingerslev J, Kessler CM, Lévesque H et al (2009) International recommendations on the diagnosis and treatment of patients with acquired hemophilia A. Haematologica 94:566–575CrossRefPubMedPubMedCentral
7.
go back to reference Saxena R, Mishra DK, Kashyap R, Choudhry VP, Mahapatra M, Bhargava M (2000) Acquired haemophilia—a study of ten cases. Haemophilia 6:78–83CrossRefPubMed Saxena R, Mishra DK, Kashyap R, Choudhry VP, Mahapatra M, Bhargava M (2000) Acquired haemophilia—a study of ten cases. Haemophilia 6:78–83CrossRefPubMed
8.
go back to reference Pathare AV, Ghamande S, Fernandes S, Bhatia S, Jijina F, Shetty S et al (1997) Acquired inhibitor to factor VIII: report of two unusual cases. Haemophilia 3:212–214CrossRefPubMed Pathare AV, Ghamande S, Fernandes S, Bhatia S, Jijina F, Shetty S et al (1997) Acquired inhibitor to factor VIII: report of two unusual cases. Haemophilia 3:212–214CrossRefPubMed
9.
go back to reference Kashyap R, Choudhry VP, Mahapatra M, Chumber S, Saxena R, Kaul HL (2001) Postpartum acquired haemophilia: clinical recognition and management. Haemophilia 7:327–330CrossRefPubMed Kashyap R, Choudhry VP, Mahapatra M, Chumber S, Saxena R, Kaul HL (2001) Postpartum acquired haemophilia: clinical recognition and management. Haemophilia 7:327–330CrossRefPubMed
10.
go back to reference Sharma R, Dash SK, Chawla R, Kansal S, Agrawal DK, Dua H (2013) Acquired hemophilia complicated by cardiorenal syndrome type 3. Indian J Crit Care Med 17:378–381CrossRefPubMedPubMedCentral Sharma R, Dash SK, Chawla R, Kansal S, Agrawal DK, Dua H (2013) Acquired hemophilia complicated by cardiorenal syndrome type 3. Indian J Crit Care Med 17:378–381CrossRefPubMedPubMedCentral
11.
go back to reference Gupta D, Chatterjee T, Sharma A, Ganguli P, Das S, Sharma S (2014) Rare case of acquired haemophilia and lupus anticoagulant. Indian J Hematol Blood Transfus 30:197–200CrossRefPubMed Gupta D, Chatterjee T, Sharma A, Ganguli P, Das S, Sharma S (2014) Rare case of acquired haemophilia and lupus anticoagulant. Indian J Hematol Blood Transfus 30:197–200CrossRefPubMed
12.
go back to reference Damodar S, Bhat P, Balasubramaniam S (2014) Symptomatic acquired haemophilia due to circulating antibodies against both factor VIII and IX in a non-haemophiliac patient. Indian J Hematol Blood Transfus 30(Suppl 1):90–92CrossRefPubMed Damodar S, Bhat P, Balasubramaniam S (2014) Symptomatic acquired haemophilia due to circulating antibodies against both factor VIII and IX in a non-haemophiliac patient. Indian J Hematol Blood Transfus 30(Suppl 1):90–92CrossRefPubMed
14.
go back to reference Franchini M, Mannucci PM (2013) Acquired haemophilia A: a 2013 update. Thromb Haemost 110:1114–1120CrossRefPubMed Franchini M, Mannucci PM (2013) Acquired haemophilia A: a 2013 update. Thromb Haemost 110:1114–1120CrossRefPubMed
15.
go back to reference Collins PW, Percy CL (2010) Advances in the understanding of acquired haemophilia A: implications for clinical practice. Br J Haematol 148:183–194CrossRefPubMed Collins PW, Percy CL (2010) Advances in the understanding of acquired haemophilia A: implications for clinical practice. Br J Haematol 148:183–194CrossRefPubMed
16.
go back to reference Lottenberg R, Kentro TB, Kitchens CS (1987) Acquired hemophilia. A natural history study of 16 patients with factor VIII inhibitors receiving little or no therapy. Arch Intern Med 147:1077–1081CrossRefPubMed Lottenberg R, Kentro TB, Kitchens CS (1987) Acquired hemophilia. A natural history study of 16 patients with factor VIII inhibitors receiving little or no therapy. Arch Intern Med 147:1077–1081CrossRefPubMed
17.
go back to reference Shurafa M, Raman S, Wollner I (1995) Disappearance of factor VIII antibody after removal of primary colon adenocarcinoma. Am J Hematol 50:149–150CrossRefPubMed Shurafa M, Raman S, Wollner I (1995) Disappearance of factor VIII antibody after removal of primary colon adenocarcinoma. Am J Hematol 50:149–150CrossRefPubMed
18.
go back to reference Shapiro A (2001) Inhibitor treatment: state of the art. Sem Hematol 38:26–34CrossRef Shapiro A (2001) Inhibitor treatment: state of the art. Sem Hematol 38:26–34CrossRef
20.
go back to reference Franchini M, Targher G, Montagnana M, Lippi G (2008) Laboratory, clinical and therapeutic aspects of acquired hemophilia A. Clin Chim Acta 395:14–18CrossRefPubMed Franchini M, Targher G, Montagnana M, Lippi G (2008) Laboratory, clinical and therapeutic aspects of acquired hemophilia A. Clin Chim Acta 395:14–18CrossRefPubMed
21.
go back to reference Collins P, Macartney N, Davies R, Lees S, Giddings J, Majer R (2004) A population based, unselected, consecutive cohort of patients with acquired haemophilia A. Br J Haematol 124:86–90CrossRefPubMed Collins P, Macartney N, Davies R, Lees S, Giddings J, Majer R (2004) A population based, unselected, consecutive cohort of patients with acquired haemophilia A. Br J Haematol 124:86–90CrossRefPubMed
22.
go back to reference Huang SY, Tsay W, Lin SY, Hsu SC, Hung MH, Shen MC (2015) A study of 65 patients with acquired hemophilia A in Taiwan. J Formos Med Assoc 114:321–327CrossRefPubMed Huang SY, Tsay W, Lin SY, Hsu SC, Hung MH, Shen MC (2015) A study of 65 patients with acquired hemophilia A in Taiwan. J Formos Med Assoc 114:321–327CrossRefPubMed
Metadata
Title
Acquired Hemophilia A: Experience of a Tertiary Care Institute from North India
Authors
Narender Kumar
Sweta Rajpal
Jasmina Ahluwalia
Sunil Bose
Varun Uppal
Neelam Varma
Pankaj Malhotra
Subhash Varma
Publication date
01-07-2018
Publisher
Springer India
Published in
Indian Journal of Hematology and Blood Transfusion / Issue 3/2018
Print ISSN: 0971-4502
Electronic ISSN: 0974-0449
DOI
https://doi.org/10.1007/s12288-017-0873-1

Other articles of this Issue 3/2018

Indian Journal of Hematology and Blood Transfusion 3/2018 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine