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Treatment of acquired factor X inhibitor by plasma exchange with concomitant intravenous immunoglobulin and corticosteroids

✍ Scribed by Cyrus C. Hsia; Mike Keeney; Annmarie A. Bosco; Anargyros Xenocostas

Publisher
John Wiley and Sons
Year
2008
Tongue
English
Weight
68 KB
Volume
83
Category
Article
ISSN
0361-8609

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✦ Synopsis

Abstract

A patient with spontaneous hemorrhage from multiple body sites was found to have markedly prolonged international normalized ratio (INR) and activated partial thromboplastin times (aPTT) with incomplete correction of aPTT on mixing studies using normal plasma. The cause of this severe hemorrhage was due to a specific factor X inhibitor. No underlying or associated diseases were found. Initial treatment with fresh frozen plasma, vitamin K, and recombinant activated factor VII (rFVIIa) was unsuccessful. However, therapy utilizing plasma exchange with concomitant intravenous immunoglobulin and corticosteroids resulted in a rapid and sustained normalization of factor X levels with a clinical hemostatic response. Am. J. Hematol., 2008. Β© 2007 Wiley‐Liss, Inc.

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