Anticoagulation for Stroke Prevention after Restoration of Haemostasis with Emicizumab in Acquired Haemophilia A

Acquired haemophilia A (AHA) is a rare haemorrhagic disorder caused by the development of autoantibodies inhibiting factor VIII function. It predominantly affects the elderly, who are often burdened with a considerable number of comorbidities, and can result in life-threatening bleeding. The managem...

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Autores principales:	Kadhim Al-Banaa, Nicolas Gallastegui-Crestani, Annette von Drygalski
Formato:	article
Lenguaje:	EN
Publicado:	SMC MEDIA SRL 2021
Materias:	acquired haemophilia a haemorrhage emicizumab anticoagulation failure venous thromboembolism, atrial fibrillation Medicine R
Acceso en línea:	https://doaj.org/article/4befdf7a71bc481082661ea7d450d9ac
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spelling	oai:doaj.org-article:4befdf7a71bc481082661ea7d450d9ac2021-11-23T16:02:20ZAnticoagulation for Stroke Prevention after Restoration of Haemostasis with Emicizumab in Acquired Haemophilia A2284-259410.12890/2021_002894https://doaj.org/article/4befdf7a71bc481082661ea7d450d9ac2021-11-01T00:00:00Zhttps://www.ejcrim.com/index.php/EJCRIM/article/view/2984https://doaj.org/toc/2284-2594Acquired haemophilia A (AHA) is a rare haemorrhagic disorder caused by the development of autoantibodies inhibiting factor VIII function. It predominantly affects the elderly, who are often burdened with a considerable number of comorbidities, and can result in life-threatening bleeding. The management of AHA consists of two aspects: inhibitor eradication with an immunomodulator and bleed control with a bypassing agent. Here we present a case of AHA with a high titre inhibitor in a patient with extensive comorbidities and atrial fibrillation in whom inhibitor eradication could not be achieved within a few weeks using corticosteroids alone. Due to coronavirus disease (COVID)-19 restrictions and complications of care, emicizumab offered an effective and convenient therapy, not only sparing the need for continued and intensified inhibitor eradication, but also allowing anticoagulation for stroke prophylaxis.Kadhim Al-BanaaNicolas Gallastegui-CrestaniAnnette von DrygalskiSMC MEDIA SRLarticleacquired haemophilia ahaemorrhageemicizumabanticoagulation failurevenous thromboembolism, atrial fibrillation MedicineRENEuropean Journal of Case Reports in Internal Medicine (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	acquired haemophilia a haemorrhage emicizumab anticoagulation failure venous thromboembolism, atrial fibrillation Medicine R
spellingShingle	acquired haemophilia a haemorrhage emicizumab anticoagulation failure venous thromboembolism, atrial fibrillation Medicine R Kadhim Al-Banaa Nicolas Gallastegui-Crestani Annette von Drygalski Anticoagulation for Stroke Prevention after Restoration of Haemostasis with Emicizumab in Acquired Haemophilia A
description	Acquired haemophilia A (AHA) is a rare haemorrhagic disorder caused by the development of autoantibodies inhibiting factor VIII function. It predominantly affects the elderly, who are often burdened with a considerable number of comorbidities, and can result in life-threatening bleeding. The management of AHA consists of two aspects: inhibitor eradication with an immunomodulator and bleed control with a bypassing agent. Here we present a case of AHA with a high titre inhibitor in a patient with extensive comorbidities and atrial fibrillation in whom inhibitor eradication could not be achieved within a few weeks using corticosteroids alone. Due to coronavirus disease (COVID)-19 restrictions and complications of care, emicizumab offered an effective and convenient therapy, not only sparing the need for continued and intensified inhibitor eradication, but also allowing anticoagulation for stroke prophylaxis.
format	article
author	Kadhim Al-Banaa Nicolas Gallastegui-Crestani Annette von Drygalski
author_facet	Kadhim Al-Banaa Nicolas Gallastegui-Crestani Annette von Drygalski
author_sort	Kadhim Al-Banaa
title	Anticoagulation for Stroke Prevention after Restoration of Haemostasis with Emicizumab in Acquired Haemophilia A
title_short	Anticoagulation for Stroke Prevention after Restoration of Haemostasis with Emicizumab in Acquired Haemophilia A
title_full	Anticoagulation for Stroke Prevention after Restoration of Haemostasis with Emicizumab in Acquired Haemophilia A
title_fullStr	Anticoagulation for Stroke Prevention after Restoration of Haemostasis with Emicizumab in Acquired Haemophilia A
title_full_unstemmed	Anticoagulation for Stroke Prevention after Restoration of Haemostasis with Emicizumab in Acquired Haemophilia A
title_sort	anticoagulation for stroke prevention after restoration of haemostasis with emicizumab in acquired haemophilia a
publisher	SMC MEDIA SRL
publishDate	2021
url	https://doaj.org/article/4befdf7a71bc481082661ea7d450d9ac
work_keys_str_mv	AT kadhimalbanaa anticoagulationforstrokepreventionafterrestorationofhaemostasiswithemicizumabinacquiredhaemophiliaa AT nicolasgallasteguicrestani anticoagulationforstrokepreventionafterrestorationofhaemostasiswithemicizumabinacquiredhaemophiliaa AT annettevondrygalski anticoagulationforstrokepreventionafterrestorationofhaemostasiswithemicizumabinacquiredhaemophiliaa
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Anticoagulation for Stroke Prevention after Restoration of Haemostasis with Emicizumab in Acquired Haemophilia A

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