A case of acquired hemophilia diagnosed incidentally on postoperative bleeding after tooth extraction

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  • OHSAWA Takayuki
    Kanagawa Dental College, Department of Oral and Maxillofacial Surgery
  • SHIMIZU Satoshi
    Kanagawa Dental College, Department of Oral and Maxillofacial Surgery
  • MIYAZAKI Hiroyuki
    Kanagawa Dental College, Department of Oral and Maxillofacial Surgery
  • KUBOTA Eiro
    Kanagawa Dental College, Department of Oral and Maxillofacial Surgery

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  • 抜歯後出血を契機として診断された後天性血友病の１例
  • ショウレイ ホウコク バッシ ゴ シュッケツ オ ケイキ ト シテ シンダン サレタ コウテンセイ ケツユウビョウ ノ 1レイ

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Abstract

Acquired hemophilia is a rare disease, diagnosed in individuals without any prior bleeding history. The incidence rate is reported to be 1 to 4 patients per million population. We report a case of acquired hemophilia diagnosed incidentally on postoperative bleeding after tooth extraction. A 71-year-old man was referred to our department because of postoperative bleeding after extraction of the lower anterior teeth. The patient had no previous episodes of bleeding tendency. Initial laboratory evaluation revealed a prolonged activated partial thromboplastin time (APTT) and decreased coagulant activity of factor VIII. Further examination revealed the presence of factor VIII inhibitors at the value of 3 Bethesda units. In our patient, the use of activated factor VII concentrates, effective for severe bleeding tendency in patients with acquired factor VII inhibitors, was unnecessary. He successfully responded to treatment with factor VIII concentrates and corticosteroids to control hemorrhage and inhibit the formation of autoantibodies against factor VIII (factor VIII inhibitors).

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