[Acquired autoantibodies directed against human factor VIIIc. Treatment of 2 hemorrhagic accidents with porcine factor VIIIc].
The emergence of an autoantibody directed against factor VIII may be responsible for severe, life-threatening haemorrhages. This rare disease is usually idiopathic, but it may be consecutive to an autoimmune disease or to the absorption of certain drugs such as penicillin. The diagnosis rests on the finding of a prolonged activated thromboplastin time with presence of a circulating anticoagulant and deep fall in factor VIII level. Two cases of severe haemorrhage successfully treated with porcine factor VIIIc are reported. The first case concerned an 80-year old woman presenting with a large haematoma of the thigh uncontrolled by injections of human factor VIIIc. The second case was that of a 24-year old woman in a state of shock due to a pleural blood effusion that occurred during heparin treatment of cerebral thrombophlebitis, combined with penicillin treatment of bronchial superinfection. In both cases the high-titer autoantibody to the human factor VIIIc did not, or little, cross with porcine factor VIIIc. Factor VIII rose after the first injection of the porcine factor, and the haemorrhage was rapidly controlled. In both cases, the autoantibody disappeared within a few months, either spontaneously or after treatment with immunosuppressants.
Centre de Transfusion Sanguine du Mans, Le Mans.
P
P
Moreau
F
F
Staikowsky
D
D
Laneelle
F
F
Dellile
D
D
Simonin
C
C
Schiffer
Y
Y
Laurian
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000276:immunology*; D001327:Autoimmune Diseases / Q000150:complications* / Q000276:immunology; D005169:Factor VIII / Q000276:immunology* / Q000627:therapeutic use; D005260:Female; D006406:Hematoma / Q000188:drug therapy / Q000209:etiology*; D006467:Hemophilia A / Q000209:etiology; D006801:Humans; D010314:Partial Thromboplastin Time; D010406:Penicillins / Q000009:adverse effects; D010996:Pleural Effusion / Q000188:drug therapy / Q000209:etiology; D013848:Thigh
D001323:Autoantibodies; D010406:Penicillins; D005169:Factor VIII
Auto-anticorps acquis contre le facteur VIIIc humain. Traitement de deux accidents hémorragiques par le facteur VIIIc porcin.