Spinal epidural haematoma in haemophilia A with inhibitors--efficacy of recombinant factor VIIa concentrate.
We report the case of a 21-year-old man with severe haemophilia A and factor VIII inhibitors who presented with an extensive spinal epidural haematoma (C2-T12), probably induced by sit-up exercises. The bleed was defined by magnetic resonance imaging of the cervical and thoracic spine and prompt treatment with recombinant factor VIIa concentrate led to complete resolution at 4 weeks. Neurological sequelae were averted and surgical decompression was not necessary. We discuss the difficulties in diagnosis and management of such a case.
Leach
M
M
Department of Haematology, Royal Hallamshire Hospital, Sheffield, UK.
Makris
M
M
Hampton
K K
KK
Preston
F E
FE
D000328:Adult; D000906:Antibodies / Q000276:immunology; D005169:Factor VIII / Q000276:immunology; D015942:Factor VIIa / Q000627:therapeutic use*; D006406:Hematoma / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D006467:Hemophilia A / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D008297:Male; D011994:Recombinant Proteins / Q000627:therapeutic use; D013115:Spinal Canal / Q000503:physiopathology
D000906:Antibodies; D011994:Recombinant Proteins; D005169:Factor VIII; D015942:Factor VIIa