Acquired factor VIII:C inhibitor (IgG) and positive direct Coombs' test (IgM) in a patient with lung carcinoma. Clinical course and immunochemical studies.
A 73-year-old man with lung squamous-cell carcinoma simultaneously developed a factor VIII:C inhibitor and a transient positive direct Coombs' test. The factor VIII:C inhibitor was characterized as a mixture of IgG1, IgG2, IgG4 with kappa and lambda light chains. The Coombs' test was IgM-specific.


METHODS
blood transfusions (packed red cells), cyclophosphamide and prednisone. Bleeding subsided without factor VIII-replacement therapy. Before death, in spite of the tumour-mass progression, factor VIII:C was normal.
D000368:Aged; D000941:Antigens / Q000037:antagonists & inhibitors; D002294:Carcinoma, Squamous Cell / Q000276:immunology*; D003298:Coombs Test; D005169:Factor VIII / Q000037:antagonists & inhibitors / Q000276:immunology; D006801:Humans; D005779:Immunodiffusion; D007070:Immunoglobulin A / Q000032:analysis; D007074:Immunoglobulin G / Q000032:analysis*; D008175:Lung Neoplasms / Q000276:immunology*; D008297:Male
D000941:Antigens; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D005169:Factor VIII