Clinical Analysis And Literature Review Of 15 Cases Of Acquired Hemophilia A

Objective: To study the clinical characteristics,diagnosis,treatment and prognosis of acquired hemophilia A(AHA)by retrospective analysis of the case data of 15 inpatients,and review the relevant literature to further understand the disease,so as to promote the clinicians’ understanding of the disease and improve the cure rate.Methods: The first affiliated hospital of Guangxi Medical University was collected from January 1,2014 to May 1,2019,and the case data of the hospitalized patients diagnosed as AHA were collected,including general data,clinical manifestations,laboratory examination results,diagnosis and treatment measures,treatment effect and so on.Results: 1.Of the 15 patients included,8 were male and 7 were female,aged between 27 and 73,with an average age of 54.3 years old;2.all the clinical manifestations of patients in addition to the original basic disease manifestations,there are varying degrees of skin and mucosal bleeding,other symptoms include muscle hematoma,hematuria,black stool and so on;3.Among them,11 cases had no definite primary disease,and 4 cases had history of Sjogren’s syndrome,pregnancy and diabetes;4.The results showed that activated partial thromboplastin time(APTT)was prolonged(55.5s-130.0s),coagulation factor VIII activity decreased(0.2-43.3%)and coagulation factor VIII inhibitor(0.85BU/ml-115.00BU/ml)were positive.Among them,8 cases had positive autoantibodies and increased tumor markers;5.According to the patient’s clinical symptoms,age and other individual conditions to give hemostasis,removal of inhibitors and other treatment,the bleeding symptoms improved in all patients,with 2 patients receiving complete remission after treatment(complete remission refers to FⅧinhibitor <0.60 BU/ml,FⅧ activity>50.0%).6.After follow-up,9 cases had no recurrence of bleeding symptoms during follow-up,and 1 case died of intracerebral hemorrhage 2 months after discharge.Conclusions: 1.AHA is an acquired coagulation dysfunction disease with muscle hemorrhage and large ecchymosis of skin as the main manifestation,which needs timely diagnosis and treatment.2.For patients with bleeding symptoms to do a good differential diagnosis,timely treatment is very important.3.Need to improve clinicians’ understanding of the diagnosis and differential diagnosis of clinical hemorrhage.