1983 Volume 24 Issue 4 Pages 468-475
This paper is concerned with a case of a 22-year-old woman in which ecchymoses caused by factor VIII inhibitor were developed on her arms and legs, 11 months after her first delivery of a normal boy.
There was no previous personal or family history of abnormal bleeding. She had received neither drugs nor blood transfusion.
On admission, factor VIII inhibitor activity was 2.3% and the titer of factor VIII inhibitor was 3.5 Bethesda units. Her chemical data of the blood were normal, and tests for antibodies, such as LE test, DNA test, microsome test, immunecomplex, RA test and thyroid test were negative.
The inhibitor was characterized as follows: it neutralized factor VIII activity rapidly at first and thereafter slowly with the prolonged incubation time, and it was eluted as an intermediate (7S) peak in gel filtration with Sephadex G-200, and neutralized with IgG or kappa antibody in neutralization tests.
By treatment with a combination of 6-mercaptopurine and prednisolone, the hemorrhagic symptoms were improved and the inhibitor disappeared after one month. Follow-up was continued as an out-patient for 18 months. She did not have any new bleeding episodes throughout the period and the inhibitor could not be demonstrated again.
