Recombinant factor VIIa in an infant with haemophilia A and inhibitors

Abstract

Post-traumatic bleeding from the gingiva in a 16-month-old boy with severe haemophilia A did not stop after treatment with factor VIII concentrate and tranexamic acid, and it was demonstrated that he had developed antibodies to factor VIII. Treatment with recombinant factor VIIa 60-90 micrograms/kg body weight four to eight times daily, together with local measures, stopped the bleeding and no complications were seen.

rVIIa therapy to secure haemostasis during central line insertion in children with high‐responding FVIII inhibitors

“…Experience of efficacy and safety with rVIIa is beginning to accumulate; however, the majority of patients thus far reported have been adults, with only a few case reports in children (Tengborn et al, 1992;Stein & Ratnoff, 1993;Bell et al, 1993). We decided to discontinue rVIIa in our patients 48 h following surgery because bleeding did not occur peri-or postoperatively; we consider central line insertion in these 1003 Short Report # 1996 Blackwell Science Ltd, British Journal of Haematology 92: 1002-1004 patients to be only a moderately invasive surgical procedure and that the addition of the antifibrinolytic agent allowed a greater margin of safety Schmidt et al, 1991).…”

Gingival and periodontal aspects of diseases of the blood and blood‐forming organs and malignancy

“…5) as can thrombocytopenia associated with Wiskott-Aldrich syndrome (150). Rare defects of platelet function such as Glanzmann's thrombasthenia (13, 65) may cause gingival bleeding; similarly, spontaneous or prolonged gingival bleeding can be a complication of hemophilia (156) and von Willebrand's disease (176). Although not a true disease of the blood and blood-forming organs, hereditary hemorrhagic telangiectasia may cause spontaneous gingival bleeding (47).…”

Management of oral bleedings with recombinant factor VIIa in children with haemophilia A and inhibitor

“…Recently, there have been several reports on the use of rFVIIa (NovoNordisk, Bagsvaerd, Denmark) in the management of bleedings and cover of surgical procedures in haemophilia patients with inhibitor to factor VIII [4–10].…”

“…Bagsvaerd, Denmark) in the management of bleedings and cover of surgical procedures in haemophilia patients with inhibitor to factor VIII [4][5][6][7][8][9][10].…”