title: Exsanguinating bleeding following tooth extraction in a 12-year-old girl: a rare case of acquired haemophilia A.
abstract: Acquired haemophilia A (AHA) is a life-threatening haemorrhagic disorder that occurs with various underlying conditions such as autoimmune disease, drug reactions, lymphoproliferative diseases, solid tumours and pregnancy/postpartum status. However, in half of all reported cases, the underlying disease is unknown. Most AHA cases develop in adults; paediatric/adolescent cases are extremely rare. The main clinical symptom is bleeding into the skin, muscles, soft tissues and/or mucous membranes. Here, we report the case of an otherwise healthy 12-year-old girl who presented with prolonged bleeding postexodontia. After being diagnosed with AHA, she was successfully treated with recombinant activated factor VII infusion and oral prednisolone. To avoid such unanticipated bleeding when performing dental extraction, preoperative haemostatic screening tests are recommended.
authors.affiliation: aDepartment of Pediatrics, Kyoto Second Red Cross Hospital, Kyoto bDepartment of Regulatory Medicine for Thrombosis cDepartment of Pediatrics, Nara Medical University, Nara dDepartment of Pediatrics, Kyoto Prefectural University of Medicine eDivision of Laboratory Medicine, Uji Tokushukai Medical Center, Kyoto, Japan.
authors.forename: Kimito
authors.initials: K
authors.lastname: Todo
authors.forename: Tadaki
authors.initials: T
authors.lastname: Ohmae
authors.forename: Toshio
authors.initials: T
authors.lastname: Osamura
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Kiyosawa
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Sugimoto
authors.forename: Midori
authors.initials: M
authors.lastname: Shima
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Imamura
authors.forename: Shinsaku
authors.initials: S
authors.lastname: Imashuku
mesh_terms: D002648:Child; D058734:Exsanguination / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D015942:Factor VIIa / Q000627:therapeutic use; D005260:Female; D006467:Hemophilia A / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D011239:Prednisolone / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000627:therapeutic use; D014081:Tooth Extraction / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D006490:Hemostatics; D011994:Recombinant Proteins; D011239:Prednisolone; C103587:recombinant FVIIa; D015942:Factor VIIa