title: Successful treatment of fulminant postoperative bleeding due to acquired haemophilia.
abstract: Acquired haemophilia is a rare but life-threatening phenomenon in patients who have undergone surgical treatment. We describe a patient with a history of pancreatic cancer and a conventional pancreaticoduodenectomy, who underwent elective resection of an enterocutaneous fistula, complicated by fulminant haemorrhagic shock, caused by acquired haemophilia A. Eventually, the bleeding was controlled by a combination of aggressive haemostatic and immunosuppressive therapy. Prompt diagnosis of acquired haemophilia is crucial to allow early and appropriate haemostatic treatment and reduce the period of increased bleeding risk by eradicating the inhibitor with immunosuppressive therapy.
authors.affiliation: Departments of Internal Medicine, Medisch Spectrum Twente, Enschede, the Netherlands.
authors.forename: L J M
authors.initials: LJ
authors.lastname: Mekenkamp
authors.forename: A
authors.initials: A
authors.lastname: Beishuizen
authors.forename: J
authors.initials: J
authors.lastname: Slomp
authors.forename: M C J C
authors.initials: MC
authors.lastname: Legdeur
authors.forename: J M
authors.initials: JM
authors.lastname: Klaase
authors.forename: R J
authors.initials: RJ
authors.lastname: Trof
mesh_terms: D000368:Aged; D001803:Blood Transfusion; D003029:Coagulants / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000627:therapeutic use; D005169:Factor VIII / Q000627:therapeutic use; D015942:Factor VIIa / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use*; D006467:Hemophilia A / Q000150:complications / Q000628:therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007412:Intestinal Fistula / Q000601:surgery*; D008297:Male; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011183:Postoperative Complications / Q000628:therapy*; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000628:therapy*; D011994:Recombinant Proteins / Q000627:therapeutic use
chemical_list: D003029:Coagulants; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D011994:Recombinant Proteins; D003520:Cyclophosphamide; D005169:Factor VIII; C103587:recombinant FVIIa; D015942:Factor VIIa