A Case Report of Acquired Hemophilia due to the Inhibitor Against Coagulation Factor VIII after Esophagectomy for Esophageal Cancer

Kentaro Kawasaki, Masato Ohsawa, Iwao Kobayashi, Shunji Nakayama, Shingo Kanaji, Hiroki Niwa, Masakazu Ohno, Yasuhiro Fujino, Masahiro Tominaga and Takeshi Nakamura

Division of Gastroenterological Surgery, Hyogo Cancer Center

We report a case of hemophilia acquired due to the inhibitor against coagulation factor VIII following esophagectomy. A 55-years-old man, undergoing esophagectomy via a left thoracoabdominal approach. The right hip swelling reported on post operative days (POD) 53, Hb of 7.5 g/dl necessitated emergency admission. Computed tomography (CT) showed the bleeding around the right hip joint. The patient had slightly prolonged prothrombin time (PT) and severely prolonged activated partial prothrombin time (APTT). We observed the man using the red cell mannitol adenine phosphate (RC-MAP) and fresh fresh-frozen plasma (FFP), but bleeding continued. And the activity of the Coagulation factor VIII was < 1%, and the inhibitor against coagulation factor VIII was > 5 BU/ml, yielding a diagnose is acquired hemophilia. However rare acquired hemophilia may be, care must be taken against it after cancer surgery.

Key words
acquired hemophilia, inhibitor against coagulation factor VIII, esophageal cancer

Reprint requests
Kentaro Kawasaki Division of Gastroenterological Surgery, Hyogo Cancer Center
13-70 Kitaoji-cho, Akashi, 673-8558 JAPAN

Accepted
January 27, 2010

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