title: Hemodialysis in a patient with severe hemophilia A and factor VIII inhibitor.
abstract: Hemophilia A is a hereditary X-linked recessive disease caused by mutations in the gene encoding factor VIII (FVIII), occurring in 1 out of 10,000 persons. Life expectancy and quality of life have dramatically improved recently in patients with hemophilia. Chronic kidney disease and need for renal replacement therapy in these patients are rare. The development of inhibitors to FVIII is the most serious complication of hemophilia and makes treatment of bleeds very challenging. We describe here a 28-year-old male patient with severe hemophilia A with presence of factor VIII inhibitor, who had end stage renal disease. Central venous access device was inserted along with infusion of factor eight inhibitor bypass activity before and after the procedure. He is currently on thrice weekly hemodialysis and doing well for 6 months without bleeding episodes. To our knowledge, hemophilia A with factor VIII inhibitor managed with hemodialysis has not been reported so far.
authors.affiliation: Department of Nephrology, Madras Medical College & Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, 600003, India.
authors.forename: Natarajan
authors.initials: N
authors.lastname: Gopalakrishnan
authors.affiliation: Department of Nephrology, Madras Medical College & Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, 600003, India.
authors.forename: Thiruvengadam
authors.initials: T
authors.lastname: Usha
authors.affiliation: Department of Nephrology, Madras Medical College & Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, 600003, India.
authors.forename: Balasubramaniyan
authors.initials: B
authors.lastname: Thopalan
authors.affiliation: Department of Nephrology, Madras Medical College & Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, 600003, India. priyamdhana@gmail.com.
authors.forename: Jeyachandran
authors.initials: J
authors.lastname: Dhanapriya
authors.affiliation: Department of Nephrology, Madras Medical College & Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, 600003, India.
authors.forename: Thanigachalam
authors.initials: T
authors.lastname: Dineshkumar
authors.affiliation: Department of Nephrology, Madras Medical College & Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, 600003, India.
authors.forename: Kaliaperumal
authors.initials: K
authors.lastname: Thirumalvalavan
authors.affiliation: Department of Nephrology, Madras Medical College & Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, 600003, India.
authors.forename: Ramanathan
authors.initials: R
authors.lastname: Sakthirajan
mesh_terms: D000328:Adult; D005169:Factor VIII / Q000037:antagonists & inhibitors*; D006467:Hemophilia A / Q000150:complications* / Q000628:therapy; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D006435:Renal Dialysis
chemical_list: D005169:Factor VIII
keywords: End stage renal disease; factor eight inhibitor bypass activity; hemodialysis; hemophilia A