title: What is the evidence for the use of immunomodulatory agents to eradicate inhibitory antibodies in patients with severe hemophilia a who have previously failed to respond to immune tolerance induction?
abstract: An 18-year-old man has severe hemophilia A that has been complicated by a high-titer inhibitory antibody (peak 170 BU/mL). He had previously failed a trial of immune tolerance induction (ITI) using daily high-dose (100 units/kg/d) factor VIII (FVIII) for 20 months and would like to know if immunomodulatory agents, with or without another course of ITI, might eradicate the inhibitor.
authors.affiliation: Wayne State University and Children's Hospital of Michigan, Detroit, MI 48201, USA. mcallagh@med.wayne.edu
authors.forename: Michael U
authors.initials: MU
authors.lastname: Callaghan
authors.forename: Patrick F
authors.initials: PF
authors.lastname: Fogarty
mesh_terms: D000293:Adolescent; D000906:Antibodies / Q000276:immunology*; D006467:Hemophilia A / Q000188:drug therapy* / Q000276:immunology*; D006801:Humans; D007108:Immune Tolerance / Q000276:immunology*; D007155:Immunologic Factors / Q000627:therapeutic use*; D008297:Male; D017211:Treatment Failure
chemical_list: D000906:Antibodies; D007155:Immunologic Factors