Acquired factor VIII deficiency in prostate adenocarcinoma presenting as multiple hematomas and hemarthrosis

Lewis, Akeem R.; Joseph, Joe K.; Pathak, Nirmal; Baseri, Babak; Luhrs, Carol

doi:10.1177/2050313x20906743

Cited by 4 publications

(11 citation statements)

References 18 publications

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“…Bleeding immediately after the surgery was reported, but delayed bleeding (>24 h postoperatively) was more common among children with a bleeding tendency. 4 In these reports, half of the children had never been diagnosed with a bleeding tendency. Therefore, even patients without bleeding disorders undergoing adenotonsillectomy are at risk of bleeding and require close monitoring with hemostatic support in the postoperative period.…”

Section: Discussionmentioning

confidence: 98%

“…Therefore, tonsillectomies for patients with bleeding tendencies require careful manipulation, ensuring good intraoperative hemostasis and postoperative care. 4 – 8 However, such patients who have never been aware of and/or pointed out their bleeding tendency before surgery may exist, and all otolaryngologists should be aware of this possibility.…”

Section: Introductionmentioning

confidence: 99%

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An incidental latent adult hemophilia case found after a tonsillectomy

Saikawa

Tsunoda

Sata

et al. 2021

SAGE Open Medical Case Reports

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Severe bleeding after a tonsillectomy may cause airway obstruction and be life-threatening. We report post-tonsillectomy bleeding in a 32-year-old patient with hemophilia A, who had not been aware of his disease for more than 30 years. He underwent tonsillectomy for recurrent tonsillitis. He denied episodes of bleeding tendency. The preoperative workup was normal, including platelet count, prothrombin time, and activated partial thromboplastin time. The surgery itself was uneventful, but severe bleeding from the inferior pole of the tonsillar bed developed 7 days after surgery. Emergency hemostasis was performed under general anesthesia in the operating room. The patient then remembered several episodes of bleeding tendency. Coagulation tests revealed a mild lack of coagulation factor VIII to 35%, and a diagnosis of hemophilia A was made. Hemophilia might only be found after surgery and can cause life-threatening complications. However, latent hemophilia detected after a tonsillectomy in a 32-year-old adult is very rare. A careful history of bleeding tendency is important to achieve a diagnosis of coagulopathy, perform a safer surgery, and prevent postoperative complications.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

An incidental latent adult hemophilia case found after a tonsillectomy

Saikawa

Tsunoda

Sata

et al. 2021

SAGE Open Medical Case Reports

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“…This uncommon bleeding diathesis is classically suspected in a postoperative or peritraumatic period, which presents as large hematomas, considerable ecchymosis, and gingival bleeding. Albeit, unprovoked easy bleeding, ecchymosis, gingival bleeding, hematuria, and hemarthrosis may also be the presenting symptoms, thereby raising suspicion for the presence of an underlying factor inhibitor [1][2][3]5].…”

Section: Discussionmentioning

confidence: 99%

“Accessory After the Factors”: A Rare Case of an Acquired Factor VIII Inhibitor in a 75-Year-Old Man on Rivaroxaban

Gutierrez¹,

Park²,

Leighton³

2021

Cureus

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Direct oral anticoagulants (DOACs) are used to treat several conditions such as non-valvular atrial fibrillation, deep vein thrombosis, and pulmonary embolism. DOACs and other anticoagulants block crucial steps in the coagulation cascade and ultimately prevent clot formation. Generally, individuals initiated on an anticoagulant are predisposed to or have a propensity to form clots. Patients with hemophilia are given anticoagulants only in very rare cases. In this report, we discuss the case of a 75-year-old man with a history of atrial fibrillation managed on rivaroxaban; he presented to the emergency department with fatigue, easy bleeding, symptomatic anemia, and significantly elevated partial thromboplastin time (PTT) with an undiagnosed acquired factor VIII inhibitor. Reports of DOAC use and concomitant factor inhibitor autoimmunization, as seen in this case, are scarcely explored in the existing literature. While DOACs are popular anticoagulants, their variable effects on both prothrombin time (PT) and PTT make it difficult to detect superimposed bleeding disorders. In patients with severe anemia or significant elevations in PT or PTT, an expedited workup, including factor assays, may be a reasonable option as evidenced by this case.

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“…Hematologic abnormalities in patients with non-hematologic malignancies are relatively common with nearly 10% experiencing abnormal bleeding 1,2 . The etiology ranges from bone marrow suppression to more acutely life-threatening conditions such as DIC or trauma to highly vascularized neoplastic tissue 3 .…”

Section: Introductionmentioning

confidence: 99%

“…The etiology ranges from bone marrow suppression to more acutely life-threatening conditions such as DIC or trauma to highly vascularized neoplastic tissue 3 . Acquired hemophilia A (AHA) is a rare condition with an incidence of 1.5 in 1000000 annually 4 and is associated with the development of autoantibodies to clotting factor VIII 2 . AHA can be caused by autoimmune disease, drug exposure, post-partum, and malignancies 5 .…”

Section: Introductionmentioning

confidence: 99%