Acquired circulating anticoagulant to factor VIII. Response to high doses of cryoprecipitate and immunosuppressive therapy

Abstract

Hematuria, arthralgias, and bleeding from subcutaneous and soft tissues developed in a 56-year-old man with an allergic background following a course of sulfisoxazole for urinary tract infection, Coagulation studies demonstrated the presence of an inhibitor to factor VIII in high titers. Massive doses of antihemophilic factor concentrate (30,000 to 60,000 units/day), azathioprine, and corticosteroids were followed by an immediate decrease in bleeding and a reduced level of inhibitor units. Three months after the onset of symptoms, the partial thromboplastin time returned to normal and inhibitor units to factor VIII became undetectable.