PO0032 - Recurrent arterial thrombosis in haemophilia A

Wednesday, July 13, 2022

1:00 PM – 2:00 PM

Location: ExCel Center, ICC Capital Suite Room 1

Presenting Author(s)

Kristína Vajdová, MD, PhD.

laboratory researcher
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia

Co-Author(s)

PH

Pavol Holly

physician-hematologist
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia
MD

Miroslava Dobrotová

physician-hematologist
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia
Monika Brunclikova, MD

physician
National Centre of Hemostasis and Thrombosis, Department of Hematology and Transfusiology, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Slovakia
Martin, Zilina, Slovakia
MS

Matej Samoš

university professor
Department of Internal Medicine I, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia
TB

Tomáš Bolek

physician-internist
Department of Internal Medicine I, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia
PK

Peter Kubisz

university professor
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia
JS

Jan Stasko

university professor
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia

Background: Haemophilia A is a X-linked recessive bleeding disorder caused by defective synthesis of coagulation factor VIII (FVIII). Anyway, it does not protect from thromboembolic events. Cardiovascular complications develop even earlier and significantly more frequently in individuals with haemophilia A than in control group.

Aims: The authors report the case of the patient with haemophilia A with repeated thrombotic episodes.

Methods: The 60-year-old man with moderate haemophilia A (FVIII 2.3-2.6%), treated initially with on demand FVIII concentrate (weight 60 kg) is presented.
Written informed consent was obtained and the study was approved by the Ethics committee of the Jessenius Faculty of Medicine. Study complies with the Declaration of Helsinki. The authors do not have any conflict of interest.

Results: At first, the patient reported the dull pain in epi- and mesogastrium irradiating to the back. The computed tomography confirmed the presence of the irregular thrombus almost in whole part of the abdominal aorta. Combination of antithrombotic agents led to disappearance of these symptoms.
In 4-years time, he was admitted to the hospital with dyspnea, bilateral rattling sounds in the lungs. This time, he was diagnosed with acute myocardial infarction with ST-segment elevation of the inferior wall, unilateral pneumonia and pleural effusion. Despite the treatment, breathlessness was still present. Finally, bronchial carcinoma with lung metastases was found.

Conclusion(s): The management of cardiovascular events in haemophiliacs is challenging especially in the situations when antithrombotic treatment or invasive procedure is planned. Thus, the optimalization of the concomitant antithrombotic and substitution therapy in patients with the coexistence of opposing disorders of haemostasis is needed.
Acknowledgement: The authors thank the support of projects of the Agency for the Support of Research and Development (APVV) APVV-16-0020 and Scientific Grant Agency (Vega) 1/0549/19.