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Thromb Haemost 1972; 28(01): 120-128
DOI: 10.1055/s-0038-1649047
Original Article
Schattauer GmbH

The Treatment of Patients Having Spontaneously Occurring Antibodies to Antihaemophilic Factor (Factor VIII)

C.R Rizza
1   Oxford Haemophilia Centre, Churchill Hospital, Oxford, the Area Department of Pathology, Church Lane, Heavitree, Exeter, the Royal Postgraduate Medical School, London, and St. Bartholomew’s Hospital, London
,
J.O.P Edgcumbe
1   Oxford Haemophilia Centre, Churchill Hospital, Oxford, the Area Department of Pathology, Church Lane, Heavitree, Exeter, the Royal Postgraduate Medical School, London, and St. Bartholomew’s Hospital, London
,
W.R Pitney   *
1   Oxford Haemophilia Centre, Churchill Hospital, Oxford, the Area Department of Pathology, Church Lane, Heavitree, Exeter, the Royal Postgraduate Medical School, London, and St. Bartholomew’s Hospital, London
,
J.A Child
1   Oxford Haemophilia Centre, Churchill Hospital, Oxford, the Area Department of Pathology, Church Lane, Heavitree, Exeter, the Royal Postgraduate Medical School, London, and St. Bartholomew’s Hospital, London
› Author Affiliations
Further Information

Publication History

Publication Date:
29 June 2018 (online)

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Summary

The appearance of antibodies to factor VIII in the blood of previously normal people is a very rare occurrence but when it does happen the haemorrhagic condition which results can be very serious and difficult to treat.

From experience of three cases described here it is recommended that treatment be witheld unless there is serious haemorrhage in which case steroids, large doses of cryoprecipitate or other human AHG should be given. In the case of life endangering haemorrhages it is justified to use the much more potent animal AHG preparations along with an immuno-suppressive drug.

* Present appointment – Professor of Medicine, Prince George Hospital, Kogarah, New South Wales, Australia.


 

  • References

  • 1 Allison A. C. 1970; Tumor development following immuno-suppression. Proceedings of the Royal Society of Medicine 63: 1077.
    PubMedGoogle Scholar
  • 2 Bidwell E, and Denson K. W. E. 1966; Antibody nature of the inhibitor to antihemophilic globulin. Nature 210: 746.
    CrossrefPubMedGoogle Scholar
  • 3 Biggs R, and Bidwell E. 1959; A method for the study of antihaemophilic globulin inhibitors with reference to six cases. British Journal of Haematology 5: 379.
    CrossrefPubMedGoogle Scholar
  • 4 Biggs R, Denson K. W. E, and Nossel H. L. 1964; A patient with an unusual circulating anticoagulant. Thrombosis et Diathesis Haemorrhagica 12: 1.
    PubMedGoogle Scholar
  • 5 Biggs R, and Macfarlane R. G. 1962. Human Blood Coagulation and Its Disorders. 3rd edn.. Blackwell Scientific Publications; Oxford:
    Google Scholar
  • 6 Brinkhous K. M, Shanbrom E, Roberts H. R, Webster W. P, Fekete L, and Wagner R. H. 1968; A new high-potency glycine precipitated antihemophilic factor (AHF) concentrate. Treatment of classical hemophilia and hemophilia with inhibitors. Journal of the American Medical Association 205: 613.
    CrossrefPubMedGoogle Scholar
  • 7 Cooke J. V, Anderson J. B, and Gamble W. S. 1962; Circulating factor VIII anti-coagulant in bullous Dermatitis. Archives of Internal Medicine 110: 511.
    CrossrefPubMedGoogle Scholar
  • 8 Doak P. B, Montgomerie J. Z, North J. D. K, and Smith F. 1968; Reticulum cell sarcoma after renal homotransplantation and azathioprine and prednisolone therapy. British Medical Journal IV: 746.
    PubMedGoogle Scholar
  • 9 Edgcumbe J. O. P. 1968 Study of acquired inhibitor to factor VIII. Abstract of the Simultaneous Sessions XIIth Congress, International Society of Haematology T. T. – 4. p. 182.
    PubMedGoogle Scholar
  • 10 Ellis H, Handley D. A, and Taylor K. B. 1959; Surgery in a patient with an acquired circulating anticoagulant. Lancet 1: 1167.
    PubMedGoogle Scholar
  • 11 Frick P. G. 1955; Acquired circulating anticoagulants in systemic “Collagen Disease”. Blood 10: 691.
    PubMedGoogle Scholar
  • 12 Green D. 1968; Spontaneous inhibitors of factor VIII. British Journal of Haematology 15: 57.
    CrossrefPubMedGoogle Scholar
  • 13 Green D. 1971; Suppression of an antibody to factor VIII by a combination of factor VIII and cyclophosphamide. Blood 37: 381.
    PubMedGoogle Scholar
  • 14 Horowitz H. I, and Fujimoto M. M. 1962; Acquired hemophilia due to a circulating anticoagulant. American Journal of Medicine 33: 501.
    CrossrefPubMedGoogle Scholar
  • 15 Margolius Jr. A., Jackson D. P, and Ratnoff O. D. 1961; Circulating anticoagulants: A study of 40 cases and a review of the literature. Medicine 40: 145.
    CrossrefPubMedGoogle Scholar
  • 16 Nilsson I. M, Skanse B, and Gydell K. 1958; Circulating anticoagulant after pregnancy and its response to ACTH. Acta Haematologica 19: 40.
    CrossrefPubMedGoogle Scholar
  • 17 Nussey A. M, and Dawson D. W. 1957; Haemophilia-like disease due to an auto-antibody. British Medical Journal 11: 1077.
    PubMedGoogle Scholar
  • 18 Robboy S. J, Lewis E. L, Schur P. H, and Colman R. W. 1970; Circulating anticoagulants to factor VIII. American Journal of Medicine 49: 742.
    CrossrefPubMedGoogle Scholar
  • 19 Shapiro S. S. 1967; The immunologic character of acquired inhibitors of antihaemophilic globulin (factor VIII) and the kinetics of their interaction with factor VIII. Journal of Clinical Investigations 46: 147.
    CrossrefPubMedGoogle Scholar
  • 20 Sherman L. A, Goldstein M. A, and Sise H. S. 1969; Circulating anticoagulant (anti-factor VIII) treated with immunosuppressive drugs. Thrombosis et Diathesis Haemorrhagica 21: 249.
    PubMedGoogle Scholar
  • 21 Whitfield A. G. W, Meynell M. J, Fessey B. M, and Hudson W. A. 1962; A circulating anticoagulant occurring after temporal arteritis and controlled by corticosteroid therapy. Journal of Clinical Pathology 15: 357.
    CrossrefPubMedGoogle Scholar
  • 22 Winckelmann G, Bottcher D, and Groh R. 1968; A circulating anticoagulant directed against anti-haemophilic globulin (factor VIII) combined with thrombocytopenia. Thrombosis et Diathesis Haemorrhagica 20: 144.
    PubMedGoogle Scholar
  • 23 Woodruff M. F. A. 1969; Immuno-suppression and its complications. Proceedings of the Royal Society of Medicine 62: 411.
    PubMedGoogle Scholar