BACKGROUND: Acquired haemophilia is an uncommon condition caused by the development of clotting factor inhibitors. To eliminate them, immunosuppressive therapy with corticosteroids and cytotoxic drugs is required. METHODS: We describe a case of rituximab use in acquired haemophilia refractory to conventional therapy in a 63 year old male patient with chronic hepatitis C virus infection who was receiving treatment with pegylated-interferon-a-2a plus ribavirin. RESULTS: After 21 weeks of antiviral therapy, the patient was admitted to hospital with a large haematoma in the abdominal muscles. Factor VIII level was zero and inhibitor titer was 345 Bethesda units. Oral immunosuppressive therapy with methylprednisolone and cyclophosphamide was administered for 1 month, with limited improvement. Therefore, cyclophosphamide was replaced by a four once-weekly dose of intravenous rituximab. Two months later, factor VIII level was normal and inhibitor titer was undetectable. CONCLUSION: Rituximab may be useful for the treatment of acquired haemophilia resistant to standard therapy.
BACKGROUND: Acquired haemophilia is an uncommon condition caused by the development of clotting factor inhibitors. To eliminate them, immunosuppressive therapy with corticosteroids and cytotoxic drugs is required. METHODS: We describe a case of rituximab use in acquired haemophilia refractory to conventional therapy in a 63 year old male patient with chronic hepatitis C virus infection who was receiving treatment with pegylated-interferon-a-2a plus ribavirin. RESULTS: After 21 weeks of antiviral therapy, the patient was admitted to hospital with a large haematoma in the abdominal muscles. Factor VIII level was zero and inhibitor titer was 345 Bethesda units. Oral immunosuppressive therapy with methylprednisolone and cyclophosphamide was administered for 1 month, with limited improvement. Therefore, cyclophosphamide was replaced by a four once-weekly dose of intravenous rituximab. Two months later, factor VIII level was normal and inhibitor titer was undetectable. CONCLUSION:Rituximab may be useful for the treatment of acquired haemophilia resistant to standard therapy.
Authors: Felipe Peña-Muñoz; Ernesto Parras; Olga Compan; Nora Gutiérrez; Celestino Martin; José Ramón González-Porras; Jose María Bastida Journal: Eur J Case Rep Intern Med Date: 2020-06-04
Authors: Giovanni D'arena; Elvira Grandone; Matteo N D Di Minno; Pellegrino Musto; Giovanni Di Minno Journal: Blood Transfus Date: 2015-09-03 Impact factor: 3.443