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  • Title: Surgery for a chronic cystic hematoma on the right thigh in a hemophiliac A with a potent factor VIII inhibitor.
    Author: Masuhara K, Shimizu T, Kawasaki N, Fukui H, Sakai Y, Shima M, Mikami S, Yoshioka A.
    Journal: Nihon Seikeigeka Gakkai Zasshi; 1982 Dec; 56(12):1719-27. PubMed ID: 6820658.
    Abstract:
    A surgical case is described of a 40-year-old hemophilia A patient with a potent factor VIII inhibitor (40 Bethesda units) suffering from a chronic cystic haematoma in the right thigh. Surgery was performed after extensive plasmapheresis and administration of a large amount of factor VIII concentrate (42,500 U on the day of operation). During the five post-operative days, the factor VIII level was maintained above 25%, which allowed control of hemorrhage. However, two serious problems, i.e., hemolytic anemia and anamnestic response of factor VIII inhibitor titer, occurred on the 6th post-operative day. The hemolytic anemia was circumvented by administering prothrombin complex concentrate every 8 hours for 12 days until the sutures were removed. There was no bleeding although the inhibitor titer rose to 460 Bethesda units.
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