Abstract
A case of 32-year-old female wjth an inhibitor against factor VIII procoagulant actvity was treated in 1975 at St. Marianna Hospital in Kawasaki city. She became ecchymotic 3 months after her second delivery. After another six months, she was diagnosed as 7 weeks pregnant and an artificial abortion was carried out due to her bleeding episodes. As the bleeding did not stop after the abortion, a hysterectomy was carried out even though bleeding from the surgical wound still persited. At this time, she was first refered to St. Marianna Hospital. Examinations at the time of admission showed a marked prolonged partial thromboplastin time (PTT) and a low level of factor VIII (1.1%). Further examinations revealed that the low level of factor VIII was due to the inhibitor against factor VIII (2.75 old Oxford unit).
The level of factor VIII was elevated to 23% and the inhibitor fell to 0.37 u when the patient was checked 7 months after the initial examination at St. Marianna Hospital. The inhibitor class of this patient was IgG. Based on the patient's clinical manifestation of the bleeding, it was suspected that she acquired the inhibitor after the 2nd delivery. It is uncertain whether the level of the inhibitor was increased due to her third pregnancy, because no examinations were performed before the third pregnancy.
