Acquired Factor VIII Inhibitor in a Non-Hemophilic Patient with Chronic Hepatitis C Viral Infection.

Abstract

Production of coagulation factor VIII inhibitor is rarely encountered in non-hemophilic patients. A 63-year-old Japanese male suffered from severe bleeding tendency caused by this inhibitor. Although he did not have malignancy or collagen disease, he had chronic hepatitis C virus (HCV)infection. Although HCVis knownto induce production of various autoimmuneantibodies, this may be the first report of a case with both acquired factor VIII inhibitor and HCV infection. (Internal Medicine 38: 283-286, 1999)

Acquired factor VIII inhibitor associated with chronic untreated hepatitis C

“…2 The development of acquired hemophilia A without previous drug exposure and without genetic hemophilia is rare, though it has been described previously by Sugishita, et al in a report of an older man with chronic hepatitis C, 9 a case similar to the one presented here. Despite the rarity of AHA precluding large-scale studies, remission is achievable using chemotherapeutic-based treatment plans.…”

Severe Acquired Hemophilia with Factor VIII Inhibition Associated with Acetaminophen and Chlorpheniramine

“…Furthermore, the production of factor VIII inhibitors seems to be an almost rare event during the course of viral or bacterial infections, except for one sporadic case described in a patient with chronic hepatitis C infection. 11 One additional point of interest is that our patient experienced a prompt clinical and laboratory response to treatment with steroids and FEIBA, and a full remission was achieved after 4 weeks of treatment. Patients with drug-induced acquired hemophilia could have a favorable clinical response to discontinuing the offending medication and administering corticosteroids, but the largest case series do not contain enough detail in favor of this strategy.…”

Acquired factor VIII inhibitor in patients with hepatitis C virus infection and the role of interferon-α: A case report

“…Therefore, it is not unexpected that autoantibodies to factor VIII be found in patients infected with the hepatitis C virus. This occurrence is rare, and only two cases have been reported [9,10] in spite of the widespread prevalence of chronic hepatitis C. Interferons possess antiviral, immunomodulatory, differentiating-inducing, antiproliferative, and anti-neoplastic effects [12,13]. Autoimmune side effects of interferon treatment are infrequent.…”

“…One case report described a patient with hemophilia A and HCV infection who developed factor VIII inhibitor after prolonged interferon-a treatment [8]. Two cases were described where an acquired factor VIII inhibitor occurred in patients with hepatitis C virus infection who were not treated with interferon [9,10].…”

“…A few cases have been reported of factor VIII inhibitors occurring in patients after prolonged treatment with interferon-a [4][5][6][7][8]. Two case reports described the occurrence of an acquired factor VIII inhibitor in patients with chronic hepatitis C only [9,10] without exposure to interferona. Another case report described a patient with hemophilia A and HCV infection, who developed an acquired factor VIII inhibitor after prolonged treatment with interferon-a [8].…”