title: Two rare complications of glioblastoma multiforme: persistent hiccup and acquired haemophilia A.
abstract: A 69-year-old man was admitted to the hospital with persistent hiccups. Computed tomography and magnetic resonance imaging of the brain were performed and revealed a glioblastoma multiforme localised in the right temporal lobe. After resection, the hiccups disappeared, suggesting that temporal areas are involved in control mechanisms of hiccups. A month later, the patient was readmitted because of skin, mucosal and soft tissue bleedings. Laboratory findings showed a prolonged aPTT, a low factor VIII activity and a factor VIII inhibitor, leading to the diagnosis of acquired haemophilia A. Acquired haemophilia A is a potentially life-threatening haemorrhagic disorder resulting from the presence of antibodies against factor VIII. We believe that this disorder developed due to exposure of factor VIII(-like) tumour antigens to the immune system. This case illustrates two yet unknown complications of a glioblastoma multiforme: persistent hiccups and acquired haemophilia A.
authors.affiliation: Department of Internal Medicine, Amphia Hospital, Breda, the Netherlands.
authors.forename: C M P G
authors.initials: CM
authors.lastname: van Durme
authors.forename: R N
authors.initials: RN
authors.lastname: Idema
authors.forename: C
authors.initials: C
authors.lastname: van Guldener
mesh_terms: D000368:Aged; D001932:Brain Neoplasms / Q000150:complications* / Q000175:diagnosis; D003937:Diagnosis, Differential; D005167:Factor VII / Q000378:metabolism; D005909:Glioblastoma / Q000150:complications* / Q000175:diagnosis; D006467:Hemophilia A / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D006606:Hiccup / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D013702:Temporal Lobe; D014057:Tomography, X-Ray Computed
chemical_list: D005167:Factor VII