Post-partum factor VIII inhibitors. A review of the literature with special reference to the value of steroid and immunosuppressive treatment.
In a retrospective study 51 published cases of post-partum factor VIII inhibitors were analyzed with regard to the outcome according to treatment. The overall outcome was favorable with 97% survival at two years. The probability of complete remission (CR, absence of the inhibitor and normalization of factor VIII activity) was almost 100% at 30 months. Steroid treatment appears to be not superior to no treatment, but patients treated with immunosuppressive drugs (cyclophosphamide, azathioprine, 6-mercaptopurine) had a significantly shorter time to CR. In the absence of a randomized trial this analysis may be helpful for decision-making in women with factor VIII post-partum inhibitors. Because of the retrospective study design, conclusions have to be regarded with caution.
Hauser
I
I
First Dept. of Internal Medicine, University of Vienna, Austria.
Schneider
B
B
Lechner
K
K
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D001327:Autoimmune Diseases / Q000097:blood* / Q000188:drug therapy / Q000401:mortality / Q000628:therapy; D002648:Child; D003131:Combined Modality Therapy; D005169:Factor VIII / Q000037:antagonists & inhibitors* / Q000276:immunology / Q000627:therapeutic use; D005260:Female; D006467:Hemophilia A / Q000097:blood* / Q000188:drug therapy / Q000276:immunology / Q000401:mortality / Q000628:therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D015993:Life Tables; D011247:Pregnancy; D011644:Puerperal Disorders / Q000097:blood* / Q000188:drug therapy / Q000276:immunology / Q000401:mortality / Q000628:therapy; D012074:Remission Induction; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D005169:Factor VIII