title: Use of recombinant factor VIIa (NovoSeven) in a haemophilia A patient with inhibitor in Kuwait.
abstract: Development of inhibitors is a known complication in some haemophiliacs receiving coagulation factor replacement therapy. We report on the successful management of a young boy with haemophilia A with inhibitor using recombinant factor VIIa. We had failed to control bleeding in this patient following his circumcision, despite infusion with high doses of factor VIII concentrate for 2 weeks. Recombinant factor VIIa is a useful 'factor VIII bypassing agent' for the control of bleeding in patients with haemophilia A and B who develop inhibitors. We suggest that severely affected haemophiliacs should be absolved of ritual circumcision as a protective measure against what might become a life-threatening haemorrhage - especially in those with inhibitors.
authors.affiliation: Al-Amiri Hospital, Clinical Laboratories, Haematology Unit, Kuwait.
authors.forename: F B
authors.initials: FB
authors.lastname: Kanyike
authors.forename: S A
authors.initials: SA
authors.lastname: Abdul-Salam
authors.forename: B
authors.initials: B
authors.lastname: Prakash
authors.forename: A
authors.initials: A
authors.lastname: Sharhan
authors.forename: N
authors.initials: N
authors.lastname: Wahib
authors.forename: A H
authors.initials: AH
authors.lastname: Youssef
mesh_terms: D016063:Blood Loss, Surgical; D002648:Child; D002944:Circumcision, Male / Q000009:adverse effects; D005169:Factor VIII / Q000008:administration & dosage / Q000276:immunology*; D015942:Factor VIIa / Q000627:therapeutic use*; D006467:Hemophilia A / Q000188:drug therapy* / Q000276:immunology / Q000601:surgery; D006470:Hemorrhage / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007518:Isoantibodies / Q000009:adverse effects / Q000097:blood*; D007730:Kuwait; D008297:Male; D011994:Recombinant Proteins / Q000627:therapeutic use
chemical_list: D007518:Isoantibodies; D011994:Recombinant Proteins; D005169:Factor VIII; D015942:Factor VIIa