Use of prothrombin complex concentrates in the treatment of a hemophilic
patient with an inhibitor of factor VIII
T Sonoda, A Solomon, S Krauss, P Cruz, FS Jones and J Levin
The course and treatment of a life-threatening hemorrhagic episode in a
patient with hemophilia A whose plasma contained a high concentration of an
inhibitor of factor VIII activity is presented. The inhibitor of factor
VIII was localized to the most anodal fractions of immunoglobulin G on
electrophoresis, and was thus presumed to be an antibody directed against
factor VIII. No therapeutic benefit occurred with infusions of massive
amounts of fresh blood and factor VIII concentrates, or with a brief course
of immunosuppressive therapy. Administration of standard and activated
prothrombin complex concentrates resulted in reduction of the partial
thromboplastin time to almost normal values and control of hemorrhage.
Eight months later, another hemorrhagic episode occurred. Although a higher
titer of inhibitor of factor VIII activity was still present in the
patient's plasma, a beneficial therapeutic response was again achieved with
standard prothrombin complex infusions.
Volume 47,
Issue 6,
pp. 983-989,
06/01/1976
Copyright © 1976 by The American Society of Hematology
