Management of traumatic oral-facial injury in the hemophiliac patient with inhibitor: case report.
This report describes identification of Factor VIII inhibitor in a patient who then received immune tolerance therapy. The precipitating event was a traumatic orofacial injury that was nonresponsive to traditional factor-replacement therapies. An inhibitor complicates medical and dental management of the hemophiliac patient because it counteracts usual techniques of hemorrhage control using coagulation agents derived from Factor VIII (Monoclate--Armour, Blue Bell, PA). Successful identification and management of the inhibitor patient require communication and consultation between the physician and dentist, up-to-date knowledge regarding the hemophiliac patient's bleeding and infusion history and aggressive application of local adjunctive hemostatic therapies.
Durham
T M
TM
UNMC General Practice Residency Program, Department of Pathology, Diagnosis and Radiology, UNMC College of Dentistry, Omaha, NE.
Hodges
E D
ED
Harper
J
J
Green
J G
JG
Tennant
F
F
D015119:Aminocaproic Acid / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D002675:Child, Preschool; D017742:Dental Care for Chronically Ill; D005151:Facial Injuries / Q000150:complications*; D005169:Factor VIII / Q000037:antagonists & inhibitors*; D006406:Hematoma / Q000628:therapy; D006467:Hemophilia A / Q000150:complications*; D006801:Humans; D007108:Immune Tolerance / Q000187:drug effects; D007167:Immunotherapy; D008297:Male; D006472:Oral Hemorrhage / Q000628:therapy; D011516:Prothrombin / Q000627:therapeutic use
D000911:Antibodies, Monoclonal; D011516:Prothrombin; D005169:Factor VIII; D015119:Aminocaproic Acid