PMID- 20622487
OWN - NLM
STAT- MEDLINE
DCOM- 20101007
LR  - 20131121
IS  - 0485-1439 (Print)
IS  - 0485-1439 (Linking)
VI  - 51
IP  - 6
DP  - 2010 Jun
TI  - [Acquired hemophilia complicated with hemorrhage induced acute renal failure].
PG  - 407-12
AB  - A 63-year-old woman, without a family history of hemophilia, was admitted to our 
      hospital because of subcutaneous bleeding, intramuscular and intra-articular 
      hematoma, and macroscopic hematuria. On routine blood analysis, a prolonged 
      activated partial thromboplastin time, decreased concentration of factor VIII to 
      less than 1%, and a markedly elevated level of factor VIII inhibitor to 14.1 
      BU/ml were revealed. Diagnosis of acquired hemophilia was made and she was 
      treated with prednisolone and recombinant activated factor VII (rFVIIa). On day 9 
      of rFVIIa therapy, she was complicated by acute renal failure (ARF) with 
      increasing macroscopic hematuria. Computed tomography revealed bilateral swelling 
      of the kidneys with bleeding and dilatation of the left renal pelvis. Activated 
      prothrombin complex concentrates (aPCC) was administrated in combination with 
      steroid pulse therapy and hydration. The bleeding tendency, including ARF, was 
      improved with aPCC, and she was treated with prednisolone and cyclophosphamide. 
      She is currently in good health and attending an outpatients' clinic. Acquired 
      hemophilia is associated with various underlying conditions, but our patient did 
      not show any previous history. ARF is a rare complication in acquired hemophilia, 
      requiring a non-invasive treatment combination with early induction of 
      immunosuppressive therapy.
FAU - Takimoto, Madoka
AU  - Takimoto M
AD  - Department of Internal Medicine, Division of Hematology and Oncology, Yokohama 
      City Seibu Hospital, St. Marianna University School of Medicine.
FAU - Nagura, Shigeki
AU  - Nagura S
FAU - Sano, Fumiaki
AU  - Sano F
FAU - Nagoshi, Haruhisa
AU  - Nagoshi H
FAU - Miura, Ikuo
AU  - Miura I
LA  - jpn
PT  - Case Reports
PT  - English Abstract
PT  - Journal Article
PL  - Japan
TA  - Rinsho Ketsueki
JT  - [Rinsho ketsueki] The Japanese journal of clinical hematology
JID - 2984782R
RN  - 0 (Immunosuppressive Agents)
RN  - 8N3DW7272P (Cyclophosphamide)
RN  - 9PHQ9Y1OLM (Prednisolone)
RN  - EC 3.4.21.21 (Factor VIIa)
RN  - X4W7ZR7023 (Methylprednisolone)
SB  - IM
MH  - Acute Kidney Injury/diagnosis/*etiology/therapy
MH  - Cyclophosphamide/administration & dosage
MH  - Factor VIIa/administration & dosage/therapeutic use
MH  - Female
MH  - Hematuria/etiology/therapy
MH  - Hemophilia A/diagnosis/*etiology/therapy
MH  - Hemorrhage/*complications/therapy
MH  - Humans
MH  - Immunosuppressive Agents/administration & dosage
MH  - Kidney Diseases/*complications/therapy
MH  - Methylprednisolone/administration & dosage
MH  - Middle Aged
MH  - Prednisolone/administration & dosage
MH  - Pulse Therapy, Drug
EDAT- 2010/07/14 06:00
MHDA- 2010/10/12 06:00
CRDT- 2010/07/13 06:00
PHST- 2010/07/13 06:00 [entrez]
PHST- 2010/07/14 06:00 [pubmed]
PHST- 2010/10/12 06:00 [medline]
AID - JST.JSTAGE/rinketsu/51.407 [pii]
PST - ppublish
SO  - Rinsho Ketsueki. 2010 Jun;51(6):407-12.