Acquired Hemophilia A:4 Cases Report And Literature Review

OBJECTIVE:To improve the diagnosis and treatment ability to acquired hemophilia A.METHODS:To discuss the clinical charactstics, diagnosis, therapy of 4 cases patients with AHA, who were diagnosed and treated in The First Affiliated Hospital of Guangxi Medical University and No.303 Hospital of Chinese Peoples Liberation Army from July 2014 to April 2016. And made a review of literature.RESULTS:The age of 4 cases patients was 44-73 years old, the incidence ratio of male to female was 1:3. There was no definite cause for the patients.The first clinical symptoms of the patients was mucocutaneous hemorrhage or muscular hematoma. All patients had isolated prolonged APTT, low level of FVIII (0.4-0.9%), positive antibody titer (10.12-115BU/ml). After treatment with corticosteroid alone or combined with cyclophosphamide, antibody titers in 4 patients were decreased and FVIII level increased, but one patient died of intracrantial hemorrhage.CLUSIONS:1.Acquire hemophilia A is a rare bleeding disease which occurs predominantly in elderly.2. Hemorrhage often occurs spontaneously, the most frequent symptom mucocutaneous hemorrhage or muscular hematoma.3.Bypass agent is recommended as optimal antihemorrhagic treatment. Corticosteroid alone or combined with cyclophosphamide is still considered as the main treatment to eradicate the inhibitors.