Postpartum acquired hemophilia A: a case report and review of the literature

doi:10.3877/cma.j.issn.2095-5820.2023.02.010

Abstract

Abstract:

Objective

To improve the laboratory diagnostic level of postpartum acquired hemophilia A (AHA) through sharing a case and reviewing relevant literatures.

Methods

Combined with the laboratory screening diagnosis process of a postpartum hemorrhagic case with normal PT/TT and prolonged APTT in routine coagulation detection and related literatures, the laboratory screening programme of this disease was discussed.

Results

AHA could be quickly diagnosed by APTT correction test and plasma coagulation factor Ⅷ activity and inhibitor titer assay.

Conclusions

The role of APTT correction test is crutial to screen hemorrhagic disease.

Key words: acquired hemophilia A, FⅧ inhibitor, activated partial thromboplastin time

Chunyuan Luo, Hangxin Liu, Yue Li, Yanmei Mai, Lingbo Shi. Postpartum acquired hemophilia A: a case report and review of the literature[J]. Chinese Journal of Clinical Laboratory Management(Electronic Edition), 2023, 11(02): 114-117,123.

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References 31

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凝血相关检测项目	结果
纤维蛋白原（FIB）/（g/L）	3.28
凝血酶原时间（PT）/s	14.80
凝血酶时间（TT）/s	17.50
患者血浆APTT（APTT1）/s	74.10
正常混合血浆APTT（APTT2）/s	29.90
正常混合血浆和患者血浆l∶1混合后即刻血浆APTT（APTT3）/s	41.40
患者血浆与正常混合血浆l∶1混合后孵育2 h APTT（APTT4）/s	57.40
患者血浆与正常混合血浆分别孵育2 h后1∶1混合APTT（APTT5）/s	50.70

凝血相关检测项目	结果
纤维蛋白原（FIB）/（g/L）	3.28
凝血酶原时间（PT）/s	14.80
凝血酶时间（TT）/s	17.50
患者血浆APTT（APTT1）/s	74.10
正常混合血浆APTT（APTT2）/s	29.90
正常混合血浆和患者血浆l∶1混合后即刻血浆APTT（APTT3）/s	41.40
患者血浆与正常混合血浆l∶1混合后孵育2 h APTT（APTT4）/s	57.40
患者血浆与正常混合血浆分别孵育2 h后1∶1混合APTT（APTT5）/s	50.70

凝血因子	活性/%	参考范围/%	抑制物浓度/（BU/ml）	参考范围/（BU/ml）
Ⅷ	1.6	70~150	1.7	0
Ⅸ	87.0	70~120	0	0
Ⅺ	75.6	70~120	0	0
Ⅻ	34.6	70~150	0	0
vWF	306.0	50~160	-	-

凝血因子	活性/%	参考范围/%	抑制物浓度/（BU/ml）	参考范围/（BU/ml）
Ⅷ	1.6	70~150	1.7	0
Ⅸ	87.0	70~120	0	0
Ⅺ	75.6	70~120	0	0
Ⅻ	34.6	70~150	0	0
vWF	306.0	50~160	-	-

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