1982 Volume 28 Issue 1 Pages 7-16
A surgical case was described of 40-year-old hemophilia A with chronic blood cyst on the right thigh and with a potent factor VIII inhibitor (40 Bethesda units). Surgery was performed under extensive plasmapheresis and a large amount of infusion of factor VIII concentrate (42, 500 U on the first operation day). During 5 days following operation, factor VIII level was maintained at over 25%, which enabled us to control hemorrhage. However, two serious problems, i. e., hemolytic anemia and anamnestic rise in factor VIII inhibitor titre, appeared on the 6th day after operation. The former healed by administration of prednisolone. For the latter problem, prothrombin complex concentrate was given every 8hrs for 12 days until the sutures of operation wound were removed. There was no bleeding although inhibitor titre rose to 460 Bethesda units.
