Management of acquired hemophilia A: Review of current evidence

Transfus Apher Sci. 2018 Dec;57(6):717-720. doi: 10.1016/j.transci.2018.10.011. Epub 2018 Oct 30.

Abstract

Acquired hemophilia A (AHA) is a rare acquired bleeding disorder caused by autoantibodies against autologous factor VIII (FVIII). It is a disease that most commonly affects the elderly, but it has been described in children and during the post-partum period. It is idiopathic in 50% of cases and is associated with autoimmune disease, malignancy, pregnancy, infection or certain medications in the other 50%. The diagnosis should be suspected in patients with an isolated prolonged aPPT without previous personal or familial bleeding history. Treating the bleeding and eradication of the inhibitor is the mainstay of treatment. The first line of treatment for acute bleeding is the use of bypassing agents. The most commonly used method for eradicating the inhibitor is immunosuppression, namely corticosteroids alone or in combination with cyclophosphamide. This review summarises current knowledge and reviews management options and guidelines.

Keywords: Acquired hemophilia; Bypassing agents; Coagulation disorders; Factor VIII; Porcine factor VIII.

Publication types

  • Review

MeSH terms

  • Animals
  • Child
  • Female
  • Follow-Up Studies
  • Health Planning Guidelines
  • Hemophilia A / diagnosis
  • Hemophilia A / therapy*
  • Humans
  • Pregnancy
  • Pregnancy Complications / therapy