Traumatic Tonsillar Hemorrhage during Hemophilia A Treatment with Emicizumab
Reports on the treatment of bleeding associated with emicizumab administration are scarce. Herein, we report the case of an eight-year-old boy with moderate hemophilia A with an inhibitor who experienced tonsillar hemorrhage while undergoing emicizumab treatment. He visited our hospital for postpran...
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| Format: | Article |
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MDPI AG
2022-03-01
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| Series: | Hematology Reports |
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| Online Access: | https://www.mdpi.com/2038-8330/14/2/16 |
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| author | Fumiya Inoue Kazuki Terada Kazuki Furudate Yasushi Noguchi Shunji Igarashi |
| author_facet | Fumiya Inoue Kazuki Terada Kazuki Furudate Yasushi Noguchi Shunji Igarashi |
| author_sort | Fumiya Inoue |
| collection | DOAJ |
| description | Reports on the treatment of bleeding associated with emicizumab administration are scarce. Herein, we report the case of an eight-year-old boy with moderate hemophilia A with an inhibitor who experienced tonsillar hemorrhage while undergoing emicizumab treatment. He visited our hospital for postprandial bloody vomiting. The activated partial thromboplastin time was 20.8 s; only a small amount of hemorrhage was observed in the retropharyngeal space, and tranexamic acid was administered. He experienced hematemesis on Day 2 of hospitalization, and fiberoptic laryngoscopy confirmed hemorrhage from the posterior tonsil. Varicose vessels were observed at the soft palate, and considering thrombosis, an emergency cauterization was performed instead of bypass therapy. In small children, observing the tonsils is difficult, and the coagulation ability of the patient with hemophilia A is inferior to that of healthy people, even under emicizumab administration. Thus, active hemorrhage assessment and appropriate hemostatic control are necessary. |
| first_indexed | 2024-03-09T23:40:18Z |
| format | Article |
| id | doaj.art-c6136be755ff42959c3ca325251722d5 |
| institution | Directory Open Access Journal |
| issn | 2038-8330 |
| language | English |
| last_indexed | 2024-03-09T23:40:18Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Hematology Reports |
| spelling | doaj.art-c6136be755ff42959c3ca325251722d52023-11-23T16:53:55ZengMDPI AGHematology Reports2038-83302022-03-0114210811110.3390/hematolrep14020016Traumatic Tonsillar Hemorrhage during Hemophilia A Treatment with EmicizumabFumiya Inoue0Kazuki Terada1Kazuki Furudate2Yasushi Noguchi3Shunji Igarashi4Department of Pediatrics, Narita Red Cross Hospital, Narita City 286-8523, JapanDepartment of Pediatrics, Narita Red Cross Hospital, Narita City 286-8523, JapanDepartment of Pediatrics, Narita Red Cross Hospital, Narita City 286-8523, JapanDepartment of Pediatrics, Narita Red Cross Hospital, Narita City 286-8523, JapanDepartment of Pediatrics, Narita Red Cross Hospital, Narita City 286-8523, JapanReports on the treatment of bleeding associated with emicizumab administration are scarce. Herein, we report the case of an eight-year-old boy with moderate hemophilia A with an inhibitor who experienced tonsillar hemorrhage while undergoing emicizumab treatment. He visited our hospital for postprandial bloody vomiting. The activated partial thromboplastin time was 20.8 s; only a small amount of hemorrhage was observed in the retropharyngeal space, and tranexamic acid was administered. He experienced hematemesis on Day 2 of hospitalization, and fiberoptic laryngoscopy confirmed hemorrhage from the posterior tonsil. Varicose vessels were observed at the soft palate, and considering thrombosis, an emergency cauterization was performed instead of bypass therapy. In small children, observing the tonsils is difficult, and the coagulation ability of the patient with hemophilia A is inferior to that of healthy people, even under emicizumab administration. Thus, active hemorrhage assessment and appropriate hemostatic control are necessary.https://www.mdpi.com/2038-8330/14/2/16emicizumabhemophilia Ahemostasistonsilactivated partial thromboplastin time |
| spellingShingle | Fumiya Inoue Kazuki Terada Kazuki Furudate Yasushi Noguchi Shunji Igarashi Traumatic Tonsillar Hemorrhage during Hemophilia A Treatment with Emicizumab Hematology Reports emicizumab hemophilia A hemostasis tonsil activated partial thromboplastin time |
| title | Traumatic Tonsillar Hemorrhage during Hemophilia A Treatment with Emicizumab |
| title_full | Traumatic Tonsillar Hemorrhage during Hemophilia A Treatment with Emicizumab |
| title_fullStr | Traumatic Tonsillar Hemorrhage during Hemophilia A Treatment with Emicizumab |
| title_full_unstemmed | Traumatic Tonsillar Hemorrhage during Hemophilia A Treatment with Emicizumab |
| title_short | Traumatic Tonsillar Hemorrhage during Hemophilia A Treatment with Emicizumab |
| title_sort | traumatic tonsillar hemorrhage during hemophilia a treatment with emicizumab |
| topic | emicizumab hemophilia A hemostasis tonsil activated partial thromboplastin time |
| url | https://www.mdpi.com/2038-8330/14/2/16 |
| work_keys_str_mv | AT fumiyainoue traumatictonsillarhemorrhageduringhemophiliaatreatmentwithemicizumab AT kazukiterada traumatictonsillarhemorrhageduringhemophiliaatreatmentwithemicizumab AT kazukifurudate traumatictonsillarhemorrhageduringhemophiliaatreatmentwithemicizumab AT yasushinoguchi traumatictonsillarhemorrhageduringhemophiliaatreatmentwithemicizumab AT shunjiigarashi traumatictonsillarhemorrhageduringhemophiliaatreatmentwithemicizumab |