[Acquired hemophilia A after an early abortion].
METHODS
A 30-year-old woman was referred to our clinic because she had developed recurrent spontaneous hematomas of both calves within the last 2 months. 6 months earlier the patient had developed an ovarian hyperstimulation syndrome after ovarian stimulation treatment and intrauterine insemination. Shortly afterwards a missed abortion (8 (th) week) had been diagnosed. A curettage was carried out.


METHODS
Routine coagulation tests confirmed a prolongation of aPTT to 90 s and a lupus anticoagulant. A high-titre factor VIII inhibitor (56 Bethesda units) was identified.


METHODS
Given these facts an acquired post-partum hemophilia was diagnosed. The patient was treated with prednisolone and immunoglobulins. The aPTT shortened to normal values. The factor VIII inhibitor and lupus anticoagulant disappeared. There were no further hematomas.


CONCLUSIONS
The simultaneous occurrence of antibodies in an altered immune state such as pregnancy is well known. In our case, acquired factor VIII inhibitor was found after an early abortion. Treatment with steroids and immunoglobulines led to the disappearance of factor VIII inhibitor and lupus anticoagulant.
Wullen
B
B
Klinik für Allgemeine Innere Medizin, Hepatologie, Gastroenterologie und Infektiologie, Zentrum für Innere Medizin, Katharinenhospital Stuttgart, Germany.
Mühlhöfer
A
A
Luz
H
H
Zoller
W G
WG
D000030:Abortion, Missed / Q000150:complications* / Q000601:surgery; D000328:Adult; D005169:Factor VIII / Q000037:antagonists & inhibitors; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006406:Hematoma / Q000209:etiology; D006467:Hemophilia A / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use; D007315:Insemination, Artificial; D016682:Lupus Coagulation Inhibitor / Q000097:blood; D016471:Ovarian Hyperstimulation Syndrome / Q000150:complications; D010314:Partial Thromboplastin Time; D011239:Prednisolone / Q000627:therapeutic use; D011247:Pregnancy
D005938:Glucocorticoids; D007136:Immunoglobulins; D016682:Lupus Coagulation Inhibitor; D005169:Factor VIII; D011239:Prednisolone