Nhân một trường hợp phát hiện kháng đông lưu hành mắc phải chống yếu tố VIII trên sản phụ sau sinh

Acquired inhibitors againt coagulant factors VIII, also termed aquired haemophilia A, neutralize its procoaglant function and result in severe or often life-threating bleeding. Acquired haemophilia A is a rare complication of pregnancy, typically appearing In the postpatrum period. The patient is a 35 years-old woman (para 0000), presented with very bleeding related to Caesarean section. After postpatrum, this patient was operated againt three times, as well as red cell, fresh frozen plasma and cryoprecipitate transfusion but not control bleeding condition. Finally, this patient was diagnosed Acqiured haemophilia A with aPTT and on incubation (2 hours. 37°C of the mixplasma ) aPTT remained prolonged, factor VIII level 2 percent. She was treated prednisone 2mg/kg/day, after 2 weeks of treament, .the patient stabilized and was discharged. However, after 4 weeks of treament with prednisone (80mg/days); the patient suddenly appeared much pain her back left hip area and quickly anemia. She was diagnosed hematoma of psoap muscle, at this times, her coagulation test showed aPTT and mix aPTT prolonged and Factor VIII was 1 percent. She was treated with Rituximab 375mg/m2/week x 4 weeks. She was good respond to this treament, her conditional still stabilized after 1 year treament with Rittuximab.