[Acquired hemophilia A in prepartum: case report and literature review].
BACKGROUND
Acquired hemophilia A (AH) is a rare hemorrhagic disorder, secondary to the occurrence of factor VIII inhibitor. In young patients, this disorder is commonly observed during the post-partum period, and has been rarely documented in the prepartum. We report a new case of a prepartum AH and review literature data.


METHODS
An isolated prolongation of the activated partial thromboplastin time (APTT) was fortuitously discovered in a 31-year-old pregnant women, with spontaneous ecchymosis of her lower limbs few days prior to delivery. Coagulation tests revealed decreased factor VIII activity (18%) and the presence of factor VIII inhibitor (1,4 Bethesda unit). In order to eradicate the autoantibody, the patient was first treated with prednisone and then with rituximab.


CONCLUSIONS
Prepartum factor VIII inhibitors need to be precociously recognized to allow prophylactic management of the delivery bleeding.
Service d'hématologie biologique, hôpital Tenon, Assistance publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris cedex 20, France. mourad.chaari@yahoo.fr
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Chaari
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Galea
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Elalamy
D000328:Adult; D001777:Blood Coagulation; D004438:Ecchymosis / Q000209:etiology; D005169:Factor VIII / Q000037:antagonists & inhibitors* / Q000276:immunology; D005260:Female; D006467:Hemophilia A / Q000175:diagnosis*; D006801:Humans; D010314:Partial Thromboplastin Time; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000175:diagnosis*
D005169:Factor VIII