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Prothrombin Complex Concentrates: Use in Treatment of Hemophiliacs With Factor VIII Inhibitors

Prothrombin Complex Concentrates: Use in Treatment of Hemophiliacs With Factor VIII Inhibitors Abstract • The development of factor VIII inhibitors has been a major problem in the management of hemophiliacs. The use of prothrombin complex concentrates (PCC) has been advocated as a method of overcoming this problem. We utilized PCC in the treatment of nine hemophiliac patients who had significant levels of inhibitor. Acute bleeding episodes were successfully treated in all nine patients. Single infusions of PCC were usually adequate for control of joint and soft tissue bleeding episodes, while multiple infusions were usually required for more serious hemorrhages. In addition, programs of repeated infusions were used to heal chronically inflamed joints in three patients. The only side effect of treatment was one episode of asymptomatic elevation of liver function values that resolved spontaneously. There were no thrombotic events associated with the PCC infusions. Therapy with PCC is recommended for the management of hemophiliacs with factor VIII inhibitors. (Am J Dis Child 132:291-293, 1978) References 1. Strauss HS: Acquired circulating anticoagulants in hemophilia A . N Engl J Med 281:866-873, 1969.Crossref 2. Robert HR, Knowles MR, Jones TL, et al: Use of factor VIII concentrates in the management of patients with factor VIII inhibitors , in Brinkhous KM (ed): Hemophilia and the New Hemorrhagic States . Chapel Hill, University of North Carolina Press, 1972, p 152. 3. Stein R, Colman R: Hemophilia with factor VIII inhibitor-elimination of anamnestic response . Ann Intern Med 79:84-87, 1973.Crossref 4. Penner J, Kelly P: Management of patients with factor VIII or IX inhibitors . Semin Throm Hemostasis 1:386-394, 1975. 5. Hruby M, Schulman I: Failure of combined factor VIII and cyclophosphamide to suppress antibody to factor VIII in hemophilia . Blood 42:919-923, 1973. 6. Kurczynski E, Penner J: Activated prothrombin complex concentrate for patients with factor VIII inhibitors . N Engl J Med 291:164-167, 1974.Crossref 7. Abildgaard C, Britton M, Harrison J: Prothrombin complex concentrate (Konyne) in the treatment of hemophilic patients with factor VIII inhibitors , J Pediatr 88:200-205, 1976.Crossref 8. Kasper CK, Aledort LM, Counts RB: A more uniform measurement of factor VIII inhibitors . Thromb Diath Haemorrh 34:869-872, 1975. 9. Sergis E, Hilgartner M: Hemophilia . Am J Nurs 72:2011-2021, 1972. 10. Allain JP, Krieger GR: Prothrombin complex concentrates in the treatment of classical hemophilia with factor VIII antibody . Lancet 2:1203, 1975.Crossref 11. Kasper C: Postoperative thromboses in hemophilia B . N Engl J Med 290:404, 1974. 12. Sonada T, Soloman A, Krauss S: Use of prothrombin complex concentrates in the treatment of a hemophilic patient with an inhibitor of factor VIII . Blood 47:983-990, 1976. 13. Blatt PM, Lundblad RL, Kingdon NS, et al: Thrombogenic materials in prothrombin complex concentrates . Ann Intern Med 81:766-770, 1974.Crossref 14. Kasper C: Thrombosis and the use of prothrombin complex concentrates . N Engl J Med 289:160, 1973. 15. Lane J, Rizza C, Shape T: Five year experience of the use of factor IX concentrate for the treatment of Christmas disease at Oxford . Br J Haematol 30:435-446, 1975.Crossref 16. White GC, Roberts HR, Kingdon HS, et al: Prothrombin complex concentrates: Potentially thrombogenic materials and clues to the mechanism of thrombosis in vivo . Blood 49:159-170, 1977. 17. Mannucci PM, Caparanio A, Ninno E, et al: Liver function tests in hemophilics receiving factor VIII concentrates . J Clin Pathol 28:620-629, 1975.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Prothrombin Complex Concentrates: Use in Treatment of Hemophiliacs With Factor VIII Inhibitors

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References (22)

Publisher
American Medical Association
Copyright
Copyright © 1978 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1978.02120280075016
Publisher site
See Article on Publisher Site

Abstract

Abstract • The development of factor VIII inhibitors has been a major problem in the management of hemophiliacs. The use of prothrombin complex concentrates (PCC) has been advocated as a method of overcoming this problem. We utilized PCC in the treatment of nine hemophiliac patients who had significant levels of inhibitor. Acute bleeding episodes were successfully treated in all nine patients. Single infusions of PCC were usually adequate for control of joint and soft tissue bleeding episodes, while multiple infusions were usually required for more serious hemorrhages. In addition, programs of repeated infusions were used to heal chronically inflamed joints in three patients. The only side effect of treatment was one episode of asymptomatic elevation of liver function values that resolved spontaneously. There were no thrombotic events associated with the PCC infusions. Therapy with PCC is recommended for the management of hemophiliacs with factor VIII inhibitors. (Am J Dis Child 132:291-293, 1978) References 1. Strauss HS: Acquired circulating anticoagulants in hemophilia A . N Engl J Med 281:866-873, 1969.Crossref 2. Robert HR, Knowles MR, Jones TL, et al: Use of factor VIII concentrates in the management of patients with factor VIII inhibitors , in Brinkhous KM (ed): Hemophilia and the New Hemorrhagic States . Chapel Hill, University of North Carolina Press, 1972, p 152. 3. Stein R, Colman R: Hemophilia with factor VIII inhibitor-elimination of anamnestic response . Ann Intern Med 79:84-87, 1973.Crossref 4. Penner J, Kelly P: Management of patients with factor VIII or IX inhibitors . Semin Throm Hemostasis 1:386-394, 1975. 5. Hruby M, Schulman I: Failure of combined factor VIII and cyclophosphamide to suppress antibody to factor VIII in hemophilia . Blood 42:919-923, 1973. 6. Kurczynski E, Penner J: Activated prothrombin complex concentrate for patients with factor VIII inhibitors . N Engl J Med 291:164-167, 1974.Crossref 7. Abildgaard C, Britton M, Harrison J: Prothrombin complex concentrate (Konyne) in the treatment of hemophilic patients with factor VIII inhibitors , J Pediatr 88:200-205, 1976.Crossref 8. Kasper CK, Aledort LM, Counts RB: A more uniform measurement of factor VIII inhibitors . Thromb Diath Haemorrh 34:869-872, 1975. 9. Sergis E, Hilgartner M: Hemophilia . Am J Nurs 72:2011-2021, 1972. 10. Allain JP, Krieger GR: Prothrombin complex concentrates in the treatment of classical hemophilia with factor VIII antibody . Lancet 2:1203, 1975.Crossref 11. Kasper C: Postoperative thromboses in hemophilia B . N Engl J Med 290:404, 1974. 12. Sonada T, Soloman A, Krauss S: Use of prothrombin complex concentrates in the treatment of a hemophilic patient with an inhibitor of factor VIII . Blood 47:983-990, 1976. 13. Blatt PM, Lundblad RL, Kingdon NS, et al: Thrombogenic materials in prothrombin complex concentrates . Ann Intern Med 81:766-770, 1974.Crossref 14. Kasper C: Thrombosis and the use of prothrombin complex concentrates . N Engl J Med 289:160, 1973. 15. Lane J, Rizza C, Shape T: Five year experience of the use of factor IX concentrate for the treatment of Christmas disease at Oxford . Br J Haematol 30:435-446, 1975.Crossref 16. White GC, Roberts HR, Kingdon HS, et al: Prothrombin complex concentrates: Potentially thrombogenic materials and clues to the mechanism of thrombosis in vivo . Blood 49:159-170, 1977. 17. Mannucci PM, Caparanio A, Ninno E, et al: Liver function tests in hemophilics receiving factor VIII concentrates . J Clin Pathol 28:620-629, 1975.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Mar 1, 1978

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