Acquired hemophilia complicated with multiple muscle abscess by <i>Nocardia</i>

• YAMANOUCHI Jun

  Department of Bioregulatory Medicine, Ehime University Graduate School of Medicine

• ABE Tamami

  Department of Bioregulatory Medicine, Ehime University Graduate School of Medicine

• AZUMA Taichi

  Department of Bioregulatory Medicine, Ehime University Graduate School of Medicine

• NARUMI Hiroshi

  Department of Bioregulatory Medicine, Ehime University Graduate School of Medicine

• FUJIWARA Hiroshi

  Department of Bioregulatory Medicine, Ehime University Graduate School of Medicine

• YAKUSHIJIN Yoshihiro

  Department of Bioregulatory Medicine, Ehime University Graduate School of Medicine

• HATO Takaaki

  Department of Bioregulatory Medicine, Ehime University Graduate School of Medicine

• YASUKAWA Masaki

  Department of Bioregulatory Medicine, Ehime University Graduate School of Medicine

Bibliographic Information

Other Title

• ノカルジアによる多発性筋膿瘍を併発した後天性血友病
• 症例報告 ノカルジアによる多発性筋膿瘍を併発した後天性血友病
• ショウレイ ホウコク ノカルジア ニ ヨル タハツセイキン ノウヨウ オ ヘイハツ シタ コウテンセイ ケツユウビョウ

Abstract

An 82-year-old man was referred to our hospital because of bilateral leg swelling and ecchymosis. A hemostatic study showed prolonged aPTT, <1% factor VIII coagulant activity, and a high titer (30.4 Bethesda Units/ml) of factor VIII inhibitor. The diagnosis of acquired hemophilia A (AHA) was made, and treatment with prednisolone (PSL) was started. Within one month of treatment, the hemorrhagic symptom disappeared, aPTT levels returned to normal, and his factor VIII inhibitor was eradicated; however, factor VIII inhibitor was detected again when PSL was decreased to 10 mg/day. We then added cyclosporine A (CyA) to PSL as a second line salvage therapy. CyA therapy resulted in the resolution of AHA with marked and prolonged efficacy; however, hot, red tumors appeared in his right arm and left thigh. Needle aspiration of the tumors revealed muscle abscess, and Nocardia brasiliensis was isolated. We started treatment with sulfamethoxazole-trimethoprim, and the abscess healed promptly without recurrence.

Journal

• Rinsho Ketsueki

  Rinsho Ketsueki 50 (6), 495-498, 2009

  The Japanese Society of Hematology

Keywords

• Acquired hemophilia A
• <i>Nocardia</i>
• mustle abscess

Details

• CRID: 1390001205035363456
• NII Article ID: 10024960378
• NII Book ID: AN00252940
• DOI: 10.11406/rinketsu.50.495
• ISSN: 18820824
• ISSN: 04851439
• NDL BIB ID: 10356370
• Web Site: http://id.ndl.go.jp/bib/10356370
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I10356370
• Web Site: https://search.jamas.or.jp/link/ui/2009352399
• Text Lang: ja
• Data Source:
  • JaLC
  • NDL
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed