<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0301-696X</journal-id>
<journal-title><![CDATA[Revista de sanidad militar]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. sanid. mil.]]></abbrev-journal-title>
<issn>0301-696X</issn>
<publisher>
<publisher-name><![CDATA[Secretaría de la Defensa Nacional, Dirección General de Sanidad]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0301-696X2018000400355</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Manifestaciones orales de la hemofilia adquirida tipo A. Reporte de un caso clínico]]></article-title>
<article-title xml:lang="en"><![CDATA[Oral manifestations of acquired hemophilia A. A clinical case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fernández-Guerra]]></surname>
<given-names><![CDATA[Carla A]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez-Menchaca]]></surname>
<given-names><![CDATA[Héctor R]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Treviño-Alanís]]></surname>
<given-names><![CDATA[Ma. Guadalupe]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Morín-Juárez]]></surname>
<given-names><![CDATA[Aarón A]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rivera-Silva]]></surname>
<given-names><![CDATA[Gerardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Monterrey  ]]></institution>
<addr-line><![CDATA[San Pedro Garza García NL]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,University of Louisville Pediatric Dentistry and Special Care Department of Orthodontics]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>USA</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad de Monterrey  ]]></institution>
<addr-line><![CDATA[San Pedro Garza García NL]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2018</year>
</pub-date>
<volume>72</volume>
<numero>5-6</numero>
<fpage>355</fpage>
<lpage>358</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0301-696X2018000400355&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0301-696X2018000400355&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0301-696X2018000400355&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción  La hemofilia tipo A adquirida es un trastorno hemorrágico poco frecuente producido por la presencia de autoanticuerpos dirigidos contra el factor VIII (FVIII) circulante. El sangrado suele aparecer en la piel, músculo, área retroperitoneal y tracto gastrointestinal; sin embargo, no es común en la cavidad oral.  Caso clínico  Presentamos el caso de una paciente de la octava década de la vida con este padecimiento, caracterizado por la presencia de ampollas sangrantes y dolorosas en la cavidad oral. El diagnóstico se estableció con un tiempo elevado de tromboplastina parcial activada (TTPa), tiempo normal de protrombina y niveles elevados de inhibidores del FVIII. La paciente fue tratada con el factor VII recombinante activado y prednisona asociada con ciclofosfamida durante seis semanas. La medicación fue suspendida cuando se normalizó el TTPa.  Discusión  El diagnóstico de hemofilia adquirida tipo A es complicado debido a que no hay antecedentes familiares de sangrado y a su etiopatogenia de origen autoinmune. La forma de presentación es un sangrado espontáneo y severo asociado con un tiempo prolongado de tromboplastina.  Conclusión  Su identificación inicial expedita y la aplicación del tratamiento son fundamentales para disminuir la tasa de mortalidad de los pacientes afectados.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  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.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Hemofilia adquirida A]]></kwd>
<kwd lng="es"><![CDATA[ampolla]]></kwd>
<kwd lng="es"><![CDATA[sangrado]]></kwd>
<kwd lng="en"><![CDATA[Acquired hemophilia A]]></kwd>
<kwd lng="en"><![CDATA[blister]]></kwd>
<kwd lng="en"><![CDATA[bleeding]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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