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Revista de sanidad militar
Print version ISSN 0301-696X
Abstract
FERNANDEZ-GUERRA, Carla A et al. Oral manifestations of acquired hemophilia A. A clinical case report. Rev. sanid. mil. [online]. 2018, vol.72, n.5-6, pp.355-358. Epub Aug 23, 2019. ISSN 0301-696X.
Introduction
Acquired hemophilia A is a hemorrhagic disorder produced by autoantibodies directed against circulating factor VIII. Bleeding often appears in the skin, muscles, the retroperitoneal area, and the gastrointestinal tract; however, it is not frequent regarding occurrence in the oral cavity.
Case report
We report an unusual case of an elderly woman in the eighth decade of life with AHA characterized by painful blood blisters in the oral cavity. The diagnosis was established with a high activated partial thromboplastin time (aPTT), normal prothrombin time and elevated levels of factor VIII inhibitor (FVIII: C). The patient was treated with the activated recombinant factor VII and prednisone associated with cyclophosphamide during six weeks. Drugs were stopped when normalization of aPTT was identified.
Discussion
The diagnosis of HAA is complicated because there is no family history of bleeding and its autoimmune etiopathogenesis. Furthermore, the clinical presentation is due to spontaneous and severe bleeding associated with a prolonged time of thromboplastin.
Conclusion
The initial identification and the application of the treatment are essential to reduce the mortality rate of those patients affected.
Keywords : Acquired hemophilia A; blister; bleeding.