Background
Case presentation
Case 1
Case 2
Date | INR | APPT (in seconds) | FVIII (in %) | FXI (in %) |
---|---|---|---|---|
November 6th | 1.07 | 77.5 | 11.2 | 119.2 |
November 7th | 1.01 | 74.1 | 2.7 | 118.2 |
November 8th | 1.07 | 82.2 | 5.9 | 111.6 |
November 9th | 1.21 | 74.8 | 6.5 | 95.4 |
November 10th | 1.12 | 85.7 | 6.7 | 113.7 |
November 11th | 1.1 | 95.7 | 3.8 | 118.1 |
November 12th | 1.2 | 84.4 | 4 | 117 |
November 13th | 1.1 | 68.6 | 16.1 | 114.8 |
November 14th | 1.01 | 62.9 | 13.5 | 111.6 |
November 15th | 1.06 | 69.4 | 15.3 | 100.7 |
November 17th | 1.11 | 80.6 | 16.6 | 114.8 |
November 19th | 1.29 | 63.1 | 35.2 | 60.3 |
November 21st | 1.09 | 84.7 | 13.4 | 112.2 |
November 22nd | 1.09 | 82.6 | 21.3 | 116 |
November 23rd | NA | NA | 3.2 | 72.9 |
November 24th | NA | NA | 5 | 53.5 |
November 25th | NA | NA | 4.9 | 53 |
November 26th | 1.18 | 150 | 5.8 | 48.3 |
Discussion
Case | Age/gender | Surgical operation | Time from surgery to bleeding | FVIII Inhibitor titer | Hemostatic treatment | Anti-inhibitor treatment | Time to disappearance of inhibitor | Outcome | Ref |
---|---|---|---|---|---|---|---|---|---|
1 | 27/F | Episiotomy | 6 days | 19BU | FIX | Cyclo | – | Death | [14] |
2 | 77/M | Retinal surgery | 4 days | NS | FVIII, Cryo | Steroids,Cyclo | NS | Remission | [15] |
3 | 25/F | Cholecystectomy | 1 day | 4UB | APCC | IVIG | NS | Reop, Remission | [16] |
4 | 47/M | Bowel resection | 4 days | 3.3UB | FVIII,Cryop | Steroids, IVIG, PLME | 40 days | 2Reop, Remission | [17] |
5 | 70/F | Cholecystectomy | 1 day | 5BU | FVIII | Steroids, 6-MP | 2 months | Reop, Death | [17] |
6 | 74/F | Coronary artery bypass | 7 days | 16BU | FVIII, APCC | Steroids, Cyclo | – | 6.5BU 8 years later | [17] |
7 | 73/M | Prostate surgery | 2 days | 42BU | – | IVIG | NS | Death | [18] |
8 | 75/M | Hernia repair | 4 days | 10.4BU | rFVIIa | Steroids, Aza, cyclo | 7 months | Reop, Remission | [19] |
9 | 79/F | Cataract surgery | 0 day | 61BU | FVIII | Steroids, IVIG | NS | Reop, Remission | [20] |
10 | 53/M | Lumbar surgery | 8 days | NS | rFVIIa | Steroids | 8 weeks | Remission | [21] |
11 | 62/M | Liver transplant | 2 days | 6BU | FVIII, PLME | Steroids | 2 months | Reop, Remission | [22] |
12 | 57/M | Brain surgery | 7 days | 2BU | FVIII | Steroids, cyclosporin | 8 weeks | Reop, Remission | [23] |
13 | 82/M | Eyelid surgery | 0 day | NS | rFVIIa | Steroids | NS | Reop, Remission | [24] |
14 | 59/M | Lumbar surgery | 0 day | 8BU | FVIII, Cryop, | Cyclo, Steroids | 15 days | Remission | [25] |
15 | 57/F | Pancreaticojejunostomy | 2 days | 117BU | FVIII, rFVIIa | Steroids | 100 days | Reop, Death | [26] |
16 | 71/M | Pancreaticojejunostomy | 5 days | 8BU | FVIII | Steroids, rituximab | 124 days | Remission | [27] |
17 | 86/F | Mohs surgery | 0 day | NS | FVIII | Steroids | NS | Reop, Remission | [28] |
18 | 63/M | PEG | 6 days | 10 BU | – | Steroids | NS | Remission | [29] |
19 | 65/M | Lysis of adhesion | 1 day | 5.5BU | rFVIIa | Steroids | NS | Reop,Remission | [30] |
20 | 79/M | Pancreaticodudenectomy | 3 days | 18.7BU | APCC | Steroids, Cyclo | 67 days | Remission | [31] |
21 | 55/M | Cardiac surgery | 0 day | 66 BU | FVIII, rFVIIa, | Steroids, Cyclo | 3 months | Reop, Remission | [32] |
22 | 62/F | choledochal cyst resection | 6 days | 2BU | rFVIIa, APCC | IVIG, rituximab, cyclosporin | 18 days | Reop, Remission | [33] |
23 | 84/M | Distal gastrectomy | 2 days | 7BU | rFVIIa, | Steroids | 230 days | Reop, Remission | [34] |