PRESENTATION a previously fit 80-year-old woman presented with a 2-week history of spontaneous and extensive bruising affecting all four limbs. The severity was such that she required a transfusion of 8 units of blood. RESULTS OF INVESTIGATIONS a markedly prolonged activated partial thromboplastin time which was only partially corrected with normal plasma; tests for lupus anticoagulant were n...

Acquired haemophilia A (AHA) is a rare hemorrhagic disease caused by an autoantibody against coagulation factor VIII. Nonhaemophiliac patients develop autoantibodies (inhibitors) directed against the factor VIII circulating coagulation protein. Disease is associated with an increased morbidity and mortality. Inhibitors against FVIII induce acute and life-threatening hemorrhagic diathesis becaus...

Pig plasmin ( Lysoflbnn) was given to 11 patients with phlebographically verified venous thrombosis, 2 of whom were treated two and three times, respectively. The effect on coagulation and fibrinolytic parameters was studied. The platelet count, Owren’s P& P ( prothrombin plus factors VII and X), plasminogen, factor XIII, and antithrombin Ill did not change during the treatment. All patients de...

Levels of the factor VIII complex were found to be raised in patients with chronic renal failure and further raised by regular dialysis. Increased fibrinogen concentrations were also found. These results suggest the existence of a prothrombotic state in uraemia that is exacerbated by haemodialysis. Ristocetin-induced platelet agglutination, however, was depressed in uraemia and worsened by dial...

A 29-year-old male patient presented with progressive deformity of his left elbow since childhood. He was constantly treated with factor VIII for severe hemophilia A. He stated that he had no other diseases and had been submitted to any surgeries. At physical examination, he presented with restricted elbow extension (Figure 1A) and had a similar deformity of the right elbow. The patient is nega...

New and expensive therapeutic products can place great pressure on health care purchasers. Often, evidence to support the inclusion of such products in the purchasing process is lacking or confusing, yet demand can be organized and forceful. In this paper we use the example of the introduction of recombinant factor VIII (rFVIII) in the management of haemophilia A, to highlight some problems pur...

Six recombinant factor VIII (rFVIII) products have been marketed worldwide. In 2013, the Research of Determinants of Inhibitor Development (RODIN) study group reported an unexpectedly high risk of inhibitor development with a second-generation full-length rFVIII (Product D) in previously untreated patients (PUPs) with severe hemophilia A (HA). In 1994, French public health authorities establish...

This report describes the management of a bleedinq episode following exodontia in a patient with severe hemophilia A and inhibitor to Factor VIII. For this patient activated prothrombin complex concentrates provided an effective method of controlling hemorrhage. Maintaining hemostasis in the surgical patient who has hemophilia A and inhibitor to Factor VIII is a difficult challenge for dentists...