Unexpected Bleeding Following Endoscopic Sinus Surgery Leading to the Rare Diagnosis of Acquired Haemophilia A
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We report a case of acquired hemophilia A following endoscopic sinus surgery. The patient was a 64-year-old man whose preoperative activated partial thromboplastin time (aPTT) was slightly prolonged. He underwent endoscopic sinus surgery for chronic rhinosinusitis with nasal polyp. Nasal bleeding occurred spontaneously on the postoperative day 3. The aPTT was prolonged at 58.9 s, with factor VIII activity of 21% and a positive factor VIII inhibitor. Treatment with factor VIII and methylprednisolone resulted in remission within 1 month. This is the first of such case reported in Korea; the patient was treated by recombinant factor VIII replacement and steroid therapy.
Abstract
We report a case of acquired hemophilia A following endoscopic sinus surgery. The patient was a 64-year-old man whose preoperative activated partial thromboplastin time (aPTT) was slightly prolonged. He underwent endoscopic sinus surgery for chronic rhinosinusitis with nasal polyp. Nasal bleeding occurred spontaneously on the postoperative day 3. The aPTT was prolonged at 58.9 s, with factor VIII activity of 21% and a positive factor VIII inhibitor. Treatment with factor VIII and methylprednisolone resulted in remission within 1 month. This is the first of such case reported in Korea; the patient was treated by recombinant factor VIII replacement and steroid therapy.
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