血友病Aインヒビター症例における第VIII因子バイパス療法下の抜歯

抄録

The development of factor VIII inhibitor is one of the most serious complications of replacement therapy of factor VIII in patients with hemophilia A. Mary literatures for appro aching hemorrhage are found, though there were few reports for management of tooth extraction in +hese patients.
We performed teeth extractions on six occasions in 4 hemophiliacs with factor VIII inhibitor under factor VIII bypassing therapy, using prothrombin complex concentrates (PCC) or activated prothrombin complex concentrates (APCC). Hemostatic management was achieved satisfactorily in all cases, except for the second time for case 1, in which hemorrhage continued for 17 days in spite of transfusion of PCC.
In this report, we deal of the details of these clinical courses and discuss the effect of bypassing therapy, including oral management.