[Bilateral prosthesis of the knee in a hemophilia A patient with an inhibitor].
A forty-one year old severe haemophiliac A (factor VIII less than 1%) complicated by an antifactor VIII inhibitor was operated on for a bilateral arthroplasty of the knees. Substitutive treatment was started by giving anti-haemophilic A cryoprecipitate at a dose of 40 IU . kg-1. The anamnestic response occurred at day 6. Consumption of the inhibitor begun with the injection of 50,000 IU of concentrated factor VIII. This method proved to be insufficient for mastering the haemorrhagic syndrome, because the antibody titre quickly reached 10 IU Oxford. Treatment was continued with Autoplex (100 IU . kg-1), during three weeks, without any clinical or biological complications. It is suggested that Autoplex be used as the substitutive treatment in cases of major surgery in severe haemophilia complicated by a factor VIII inhibitor.
D000328:Adult; D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D005164:Factor IX / Q000627:therapeutic use; D015949:Factor IXa; D005169:Factor VIII / Q000037:antagonists & inhibitors*; D006467:Hemophilia A / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007432:Intraoperative Period; D007592:Joint Diseases / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male
D000933:Antifibrinolytic Agents; D005169:Factor VIII; D005164:Factor IX; D015949:Factor IXa
Prothèse bilatérale de genou chez un hémophile A avec inhibiteur.