PO0039 - With uncontrollable bleeding complications a case history of moderate Hemophilia A with Inhibitor

Wednesday, July 13, 2022

1:00 PM – 2:00 PM

Location: ExCel Center, ICC Capital Suite Room 1

Presenting Author(s)

GS

Gayane Sargsyan

Co-Author(s)

GT

Gevorg N. Tamamyan

Head of the Department of Pediatric Oncology and Hematology, Yerevan State Medical University
Armenian Hemophilia and Thrombosis Treatment center
Yerevan, Yerevan, Armenia
NS

Nelli S. Sargsyan

MD
Armenian Hemophilia and Thrombosis Treatment center
Yerevan, Yerevan, Armenia
SD

Samvel Danelyan

Hematologist
Hematology center after prof. R.H.Yeloyan, Yerevan, Armenia
Yerevan, Yerevan, Armenia
LS

Lusine Sahakyan

Hematologist
Hematology center after prof. R.H.Yeloyan, Yerevan, Armenia
Yerevan, Yerevan, Armenia
AV

Astghik Voskanyan

Hematologist-oncologist
Hematology Center after Prof. R.H. Yeolyan, Yerevan, Armenia
Yerevan, Yerevan, Armenia
Anahit Ter-Grigoryan

Head of Center
Armenian Hemophilia and Thrombosis Center Yerevan State Medical University, Department of Pediatric Oncology and Hematology
Yerevan, Yerevan, Armenia
LH

Liana Hambardzumyan, Phd

MD
Armenian Hemophilia and Thrombosis Treatment center
Yerevan, Yerevan, Armenia

Background: Hemophilia treatment center reports a case of a 38-year-old male with the second degree of disability without history of previous disease. He was diagnosed with hemophilia in December 1985.

Aims: This was the first time we had a case of such complexity in our hospital. The case report summarizes the successful treatment of a patient with hemophilia A and major bleeding, and also it became clear that having several patients with such severe bleeding could deplete the blood bank reserves.

Methods: A retrospective review of the patient’s medical history was performed.

Results: As a result of clinical diagnosis, he was diagnosed with Hemophilia A inhibitor version, which was accompanied by acute mucosal bleeding. The patient had acute nasal bleeding, gastrointestinal bleeding and two episodes of tamponade, arterial embolization and coagulation with endoscopic intervention in the posterior nasal cavity.
Among the complications he had 2 episodes of endoscopic coagulation, hematoma of the palate and the nasal cavity, erosive surfaces.
He had HCV infection, chronic ulcer disease, obesity, encephalopathy, arterial hypertension from concomitant diseases.
The patient was hospitalized on December 11 and discharged on the 30th, thus spending 19 bed days in the clinic.
The subsequent tests revealed low factor VIII and high inhibitor levels (VIII 3 % and inhibitor titer 5,5 BE Units/mL). The patient weighed 130 kg. Management relies on a rapid and accurate diagnosis, control of bleeding episodes. Appropriate treatment was prescribed, the patient was managed with medications resulting in normalization of factor VIII levels.

Conclusion(s): All medical resources have been used for the prevention and treatment of bleeding in one patient. The bottom line is that on average, hemophiliacs are the most vulnerable group, especially in the presence of hepatitis, especially in the presence of overweight, especially in countries where the drug problem has not been resolved.