Inhibitors in Hemophilia A with Posterior Dextra Femoral Region Hematoma

Abstract

Hemophili A is a hereditary coagulation disorder caused by deficiency or dysfunction of clotting factor (F) VIII. FVIII inhibitors are antibodies that functionally have the ability to inhibit FVIII activity. Patients are suspected of having FVIII inhibitors if the response to FVIII replacement therapy is inadequate. In this research, we observed a case of a 60-year-old woman with complaints of pain and swelling of her right thigh for the past 3 days. Physical examination revealed anemic conjunctiva and hematoma in the right posterior femur region. Laboratory results showed Hb 9.1 g / dL, WBC 10.96 / μL, PLT 351.000 / μL, APTT 74 seconds, CT 40 minutes, FVIII 1% and inhibitor assay 928 BU. Patient received Koate therapy, tranexamic acid and RICE (Rest, Ice, Compression, Elevation). Hemophilia A cases are generally seen in males with history of bleeding in the family and most often characterized by repeated bleeding in the joints. In this case, we found a female patient with a hematoma in the right posterior femur region. The result of FVIII examination was 1% and inhibitor assay was 928 BU. It can be concluded that the patient in this case suffered from hemophilia A with inhibitor.