The first case of acquired hemophilia <scp>A</scp> associated with <scp>SARS‐CoV</scp>‐2 infection

Franchini, Massimo; Glingani, Claudia; Donno, Giuseppe De; Casari, Salvatore; Caruso, Beatrice; Terenziani, Isabella; Perotti, Cesare; Fante, Claudia Del; Sartori, Filippo; Pagani, Mauro

doi:10.1002/ajh.25865

Cited by 58 publications

(64 citation statements)

References 5 publications

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“…Autoimmune thrombotic thrombocytopenic purpura has been demonstrated in two COVID-19 patients and improved after plasmapheresis (124,125). Another 66year-old man whose acquired hemophilia flared concomitantly with COVID-19 infection, responded to corticosteroids and cyclophosphamide (126). In summary, many cases of ITP or AIHA associated with COVID-19 have been reported, implying a possible link between them.…”

Section: Hematological Manifestationsmentioning

confidence: 87%

Autoimmune and Rheumatic Manifestations Associated With COVID-19 in Adults: An Updated Systematic Review

2021

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Background: Numerous cases of the coronavirus disease 2019 (COVID-19) with autoimmune and rheumatic manifestations have been reported. Despite the available reviews that summarized its autoimmune/rheumatic manifestations, a systematic approach is still lacking. Therefore, we conducted a comprehensive systematic review in order to give an overview upon these rare but clinically significant manifestations.Methods: We performed a literature search of PubMed and EMBASE as of October 9, 2020. All articles relevant to either systemic or organ-specific autoimmune and rheumatic manifestations potentially associated with COVID-19 were collected. The reviewed literature were limited to adults ≥18 years.Results: Although most of the existing evidence was based on case reports or case series without a long-term follow-up, a variety of autoimmune/rheumatic manifestations were associated with COVID-19. The manifestations that have a consistent association with COVID-19 include autoimmune cytopenia, cutaneous vasculitis, encephalitis, and Guillain-Barre syndrome. Such association is conflicting as regards to antiphospholipid syndrome, hemophagocytic lymphohistiocytosis, and myasthenia gravis.Conclusion: Our systematic review indicated the potential of the COVID-19 virus to trigger a myriad of autoimmune and rheumatic manifestations, which should be considered amid global efforts to combat COVID-19.

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Section: Hematological Manifestationsmentioning

confidence: 87%

Autoimmune and Rheumatic Manifestations Associated With COVID-19 in Adults: An Updated Systematic Review

2021

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“…On the other hand, haemorrhagic symptoms seem far less commonly associated with the COVID-19 infection[ 11 , 12 ]. Exceptionally, acquired haemophilia A has been reported to be triggered by COVID-19 infection [ 13 ]. Additionally, there is a theoretical risk of bleeding tendency with some drugs used in specific protocols for COVID-19 [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Management of COVID-19 Coagulopathy in a Patient with Severe Haemophilia A

et al. 2020

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A 54-year-old man with a long history of severe haemophilia A treated prophylactically with efmoroctocog alpha (3,000 IU twice weekly) was diagnosed with COVID-19 infection. He had multiple risk factors for COVID-19 severity including obesity, diabetes mellitus and hypertension. He required prolonged intensive care unit (ICU) stay due to the severity of respiratory failure until his death on day 24. During his ICU stay, he received a continuous infusion of efmoroctocog alpha in order to maintain factor VIII activity between 80 and 100%, together with therapeutic doses of low-molecular-weight heparin targeting anti-Xa activity above 0.5 IU/mol. He tolerated numerous invasive procedures without bleeding. At post-mortem examination, there was no evidence for thrombosis or haemorrhage in the different organs.

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“…The Nascimento trial reported eight TEEs total, four in each group (FC and placebo) in their Table 3. 3 However, in Figure 6 FC/TEE forest plot in Wirtz et al, they report eight total TEEs, but five in the FC group and three in the "No FC" group.…”

Section: Response To Wirtz Et Al: the Impact Of Blood Product Ratio Amentioning

confidence: 94%

“…This case joins the growing literature on acquired immunohematologic complications during or immediately following SARS-CoV-2 infection. [2][3][4][5][6][7] As a caveat, this is only the second case of an FVIII inhibitor in association with SARS-CoV-2, and until more cases are identified, it is prudent to consider the possibility that these findings are coincidental. Nonetheless, it is likely useful for the transfusion medicine, coagulation, and hematology communities to be vigilant for bleeding following SARS-CoV-2 infection and to include de novo acquired hemophilia in their differential diagnosis.…”

Section: De Novo Acquired Hemophilia As An Immune Dysregulation Phenomentioning

confidence: 96%

“…To the Editor Acquired hemophilia A is an antibody-mediated coagulopathy most often associated with pregnancy, autoimmunity, malignancy, drugs, or infection. 1 While coagulopathy, generally associated with thrombotic complications, is well described during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and a recent report linked SARS-CoV-2 with reemergence of a patientʼs acquired hemophilia A, 2,3 to date there have been no reported cases of de novo acquired hemophilia with this viral process. We report here a novel case of immune dysregulation following SARS-CoV-2 infection giving rise to factor VIII (FVIII) autoantibodies in a patient with no prior history of acquired hemophilia or other bleeding disorders.…”

Section: De Novo Acquired Hemophilia As An Immune Dysregulation Phenomentioning

confidence: 99%

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De novo acquired hemophilia as an immune dysregulation phenomenon following SARS‐CoV‐2 infection

2021

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The first case of acquired hemophilia A associated with SARS‐CoV‐2 infection

Cited by 58 publications

References 5 publications

Autoimmune and Rheumatic Manifestations Associated With COVID-19 in Adults: An Updated Systematic Review

Autoimmune and Rheumatic Manifestations Associated With COVID-19 in Adults: An Updated Systematic Review

Management of COVID-19 Coagulopathy in a Patient with Severe Haemophilia A

De novo acquired hemophilia as an immune dysregulation phenomenon following SARS‐CoV‐2 infection

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