https://doi.org/10.4081/reumatismo.2023.1585
Acquired hemophilia A treated with rituximab in a 62-year-old female with rheumatoid arthritis: a case-based review
Submitted: 23 April 2023
Accepted: 14 September 2023
Published: 19 December 2023
Accepted: 14 September 2023
Abstract Views: 904
PDF: 251
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Acquired hemophilia A (AHA) is a rare autoimmune disorder with unpredictable hemostasis that is caused by autoantibody formation against coagulation factor VIII. AHA can occur in the context of autoimmune inflammatory rheumatic disorders. Here we report the case of a 62-year-old female with an 11-year history of rheumatoid arthritis (RA) who presented with cutaneous and mucosal bleeding. Activated partial thromboplastin time was prolonged and not corrected by the mixing test. Factor VIII activity was decreased, and the anti-factor VIII antibody was positive. AHA associated with RA was diagnosed. The patient was treated with rituximab 500 mg weekly for 4 doses and prednisolone 10 mg/daily. The patient did not experience bleeding events after treatment, and factor VIII activity and inhibitor normalized. At the end of the article, we discuss similar cases of RA-associated AHA.
Zhang P, Liu J, Tan B, Zhu F, Fang L. Hypercoagulable state is associated with NF-kappa B activation and increased inflammatory factors in patients with rheumatoid arthritis. Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi 2016; 32: 364-8. [Article in Chinese].
Franchini M, Gandini G, Di Paolantonio T, Mariani G. Acquired hemophilia A: a concise review. Am J Hematol 2005; 80: 55-63.
DOI: https://doi.org/10.1002/ajh.20390
Kruse‐Jarres R, Kempton CL, Baudo F, Collins PW, Knoebl P, Leissinger CA, et al. Acquired hemophilia A: updated review of evidence and treatment guidance. Am J Hematol 2017; 92: 695-705.
DOI: https://doi.org/10.1002/ajh.24777
Tiede A, Collins P, Knoebl P, Teitel J, Kessler C, Shima M, et al. International recommendations on the diagnosis and treatment of acquired hemophilia A. Haematologica 2020; 105: 1791-801.
DOI: https://doi.org/10.3324/haematol.2019.230771
Shetty S, Bhave M, Ghosh K. Acquired hemophilia a: diagnosis, aetiology, clinical spectrum and treatment options. Autoimmun Rev 2011; 10: 311-6.
DOI: https://doi.org/10.1016/j.autrev.2010.11.005
Tang Q, Liao J, Xie X. Acquired hemophilia associated with rheumatic diseases: a case-based systematic review. J Inflamm Res 2022; 15: 4385-93.
DOI: https://doi.org/10.2147/JIR.S369288
Soriano RM, Matthews JM, Guerado-Parra E. Acquired haemophilia and rheumatoid arthritis. Br J Rheumatol 1987; 26: 381-3.
DOI: https://doi.org/10.1093/rheumatology/26.5.381
Struillou L, Fiks-Sigaud M, Barrier JH, Blat E, Magadur-Joly G. Acquired hemophilia and rheumatoid arthritis. Value of intravenous immunoglobulins. Rev Rhum Ed Fr 1993; 60: 524-6. [Article in French].
Ruiz-Calderón AJ, Carrasco F, Duro R, Constantino M. Acquired factor VIII inhibitor in a patient with rheumatoid arthritis. Sangre 1993; 38: 403-5. [Article in Spanish].
Jones SM, Dippy JE, Gaywood IC. Acquired haemophilia presenting with a haemarthrosis in a patient with rheumatoid arthritis and carcinoma of the lung. Br J Rheumatol 1994; 33: 992.
DOI: https://doi.org/10.1093/rheumatology/33.10.992
Nishino Y, Ueki K, Suto M, Uchiumi H, Ota F, Tamura S, et al. Successful treatment of patients with rheumatic disorders and acquired factor VIII inhibitors with cyclophosphamide and prednisolone combination therapy: two case reports. J Int Med Res 2001; 29: 432-6.
DOI: https://doi.org/10.1177/147323000102900508
Sato T, Hagiwara K, Chikazoe J, Nakagawa Y, Akiyama O. A case of acquired hemophilia caused by factor VIII inhibitor with rheumatoid arthritis, successfully treated with immunosuppressive treatment and recombinant activated factor VII. Mod Rheumatol 2004; 14: 320-2.
DOI: https://doi.org/10.1007/s10165-004-0317-2
Patel RS, Harman KE, Nichols C, Burd RM, Pavord S. Acquired haemophilia heralded by bleeding into the oral mucosa in a patient with bullous pemphigoid, rheumatoid arthritis, and vitiligo. Postgrad Med J 2006; 82: e3.
DOI: https://doi.org/10.1136/pgmj.2005.036483
Oliveira B, Arkfeld DG, Weitz IC, Shinada S, Ehresmann G. Successful rituximab therapy of acquired factor VIII inhibitor in a patient with rheumatoid arthritis. J Clin Rheumatol 2007; 13: 89-91.
DOI: https://doi.org/10.1097/01.rhu.0000260656.05638.f7
Freire M, Teodoro RB, Nogueira DA, Rita DP, Ribeiro Filho E, Sousa LV. Acquired hemophilia associated with rheumatoid arthritis. Bras J Rheumatol 2009; 49: 302-7.
DOI: https://doi.org/10.1590/S0482-50042009000300011
Arthanari S, Ahmad H, Nisar M. Fatal acquired hemophilia A in a patient with rheumatoid arthritis treated with adalimumab. J Clin Rheumatol 2012; 18: 50-1.
DOI: https://doi.org/10.1097/RHU.0b013e31823ee3cd
Drobiecki A, Pasiarski M, Hus I, Sokolowska B, Watek M. Acquired hemophilia in the patient suffering from rheumatoid arthritis: case report. Blood Coagul Fibrinolysis 2013; 24: 874-80.
DOI: https://doi.org/10.1097/MBC.0b013e3283646635
Banse C, Benhamou Y, Lequerré T, Le Cam-Duchez V, Lévesque H, Vittecoq O. Acquired hemophilia possibly induced by etanercept in a patient with rheumatoid arthritis. Joint Bone Spine 2015; 82: 200-2.
DOI: https://doi.org/10.1016/j.jbspin.2014.12.003
Barbosa OA, Evangelista PD, Paiva JG, de Lima TG, Brasileiro RB, Neto RR, et al. Acquired hemophilia secondary to rheumatoid arthritis: case report and literature review. J Hematol 2016; 5: 34-7.
DOI: https://doi.org/10.14740/jh255w
Hashimoto A, Takafuta T, Kido M, Okikawa Y, Ito T. Successful management of recurrent bleeding with tocilizumab in an acquired hemophilia A patient with rheumatoid arthritis. Rinsho Ketsueki 2017; 58: 738-42. [Article in Japanese].
Jaber MA, Bortolotti R, Martinelli S, Felicetti M, Aloisi T, Paolazzi G. Acquired hemophilia in a patient with rheumatoid arthritis: case report and literature review. Clin Manag Issues 2018; 12.
DOI: https://doi.org/10.7175/cmi.v12i1.1362
Ghozlani I, Mounach A, Ghazi M, Kherrab A, Niamane R. Targeting acquired hemophilia a with rheumatoid arthritis by a rituximab shot: a case report and review of the literature. Am J Case Rep 2018; 19: 582-8.
DOI: https://doi.org/10.12659/AJCR.908854
Majeranowski A, Lebiedziński F, Topolewska I, Cegła A, Palus D, Osowski J, et al. Acquired hemophilia A secondary to rheumatoid arthritis. J Transf Med 2022; 15: 57-9.
DOI: https://doi.org/10.5603/JTM.2022.0005
How to Cite
Mohamadzadeh, D., Assar, S., & Farsad, F. (2023). Acquired hemophilia A treated with rituximab in a 62-year-old female with rheumatoid arthritis: a case-based review. Reumatismo, 75(4). https://doi.org/10.4081/reumatismo.2023.1585
Copyright (c) 2023 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
Similar Articles
- R. Talotta, A. Berzi, F. Atzeni, D. Dell'Acqua, P. Sarzi Puttini, D. Trabattoni, Evaluation of Th9 lymphocytes in peripheral blood of rheumatoid arthritis patients and correlation with anti-tumor necrosis factor therapy: results from an in vitro pivotal study , Reumatismo: Vol. 68 No. 2 (2016)
- P. Sarzi-Puttini, F. Salaffi, M. Di Franco, L. Bazzichi, G. Cassisi, R. Casale, M. Cazzola, S. Stisi, M. Battellino, F. Atzeni, Pain in rheumatoid arthritis: a critical review , Reumatismo: Vol. 66 No. 1 (2014)
- A. Fassio, L. Idolazzi, M.A. Jaber, C. Dartizio, O. Viapiana, M. Rossini, D. Gatti, The negative bone effects of the disease and of chronic corticosteroid treatment in premenopausal women affected by rheumatoid arthritis , Reumatismo: Vol. 68 No. 2 (2016)
- L. Bazzichi, D. Biasi, E. Tinazzi, M. Muratore, R. Pellerito, R. Russo, M. Corsaro Santi, P. De Sandre, O. Epis, M. Granata, B. Kroegler, C. Meschini, F. Versace, C. Astolfi, Safety of rituximab in the routine treatment of rheumatoid arthritis in Italy in patients refractory to anti-TNFa drugs: results from the observational retrospective-prospective RUBINO study , Reumatismo: Vol. 66 No. 3 (2014)
- G. Cafaro, A. Alunno, V. Valentini, M.C. Leone, E. Marcucci, E. Bartoloni, R. Gerli, The onset site of rheumatoid arthritis: the joints or the lung? , Reumatismo: Vol. 68 No. 4 (2016)
- S.M. Gamal, A.K. Alkemary, M.A. Abdo, A.H.M. El Dakrony, Low body mass index in long standing rheumatoid arthritis: relation to RA disease activity and functional indices , Reumatismo: Vol. 70 No. 2 (2018)
- M. Todoerti, W. Maglione, E. Bernero, A. Bortoluzzi, M. Colaci, E. Galuppi, S. Paolino, R. Talarico, M. Cutolo, C. Ferri, F. Trotta, S. Bombardieri, C.M. Montecucco, L. Sinigaglia, Systematic review of 2008-2012 literature and update of recommendations for the use of methotrexate in rheumatic diseases, with a focus on rheumatoid arthritis , Reumatismo: Vol. 65 No. 5 (2013)
- G. Farronato, C. Bellintani, U. Garagiola, P. Cressoni, P. Sarzi Puttini, F. Atzeni, M. Cazzola, Three-dimensional morphological condylar and mandibular changes in a patient with juvenile idiopathic arthritis: interdisciplinary treatment , Reumatismo: Vol. 66 No. 3 (2014)
- M. Romano, I. Pontikaki, M. Gattinara, I. Ardoino, C. Donati, P. Boracchi, P.L. Meroni, V. Gerloni, Drug survival and reasons for discontinuation of the first course of biological therapy in 301 juvenile idiopathic arthritis patients , Reumatismo: Vol. 65 No. 6 (2013)
- S. Chandrashekara, V. Shobha, B.G. Dharmanand, R. Jois, S. Kumar, K.M. Mahendranath, V. Haridas, S. Prasad, Y. Singh, M.A. Daware, A. Swamy, R. Subramanian, S.A. Somashekar, A.M. Shanthappa, K.R. Anupama, Comorbidities and related factors in rheumatoid arthritis patients of south India- Karnataka Rheumatoid Arthritis Comorbidity (KRAC) study , Reumatismo: Vol. 69 No. 2 (2017)
<< < 1 2 3 4 5 6 7 8 9 10 > >>
You may also start an advanced similarity search for this article.
