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A case of acquired hemophilia A diagnosed after percutaneous endoscopic gastrostomy

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Abstract

A 65-year-old male with no personal or familial history of bleeding disorders underwent percutaneous endoscopic gastrostomy (PEG) for neurogenic dysphagia due to subarachnoid hemorrhage. On postoperative day 6, continuous oozing of venous blood was observed at the stoma. Prothrombin time was within normal range, but activated partial thromboplastin time was prolonged. Cross-mixing test results indicated the existence of an inhibitor, and laboratory findings revealed decreased factor VIII activity and high levels of factor VIII inhibitor. The patient was diagnosed as having acquired hemophilia A, for which steroid monotherapy was effective. Acquired hemophilia A is a rare but potentially fatal disease. Clinicians should be aware of this condition in patients presenting with sudden hemorrhage after PEG or other endoscopic treatments, even in those with no apparent history of bleeding.

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Acknowledgments

We thank Trevor Ralph for his English editorial assistance.

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Authors and Affiliations

  1. Department of Gastroenterology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan

    Takuma Okamura, Michiharu Komatsu, Akihiro Ito, Tetsuya Ito, Tomoaki Suga & Eiji Tanaka

  2. Endoscopic Examination Center, Shinshu University Hospital, Matsumoto, Japan

    Norikazu Arakura

  3. Department of Hematology, Shinshu University School of Medicine, Matsumoto, Japan

    Hitoshi Sakai

Authors
  1. Takuma Okamura
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  2. Michiharu Komatsu
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  3. Akihiro Ito
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  4. Tetsuya Ito
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  5. Tomoaki Suga
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  6. Norikazu Arakura
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  7. Hitoshi Sakai
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  8. Eiji Tanaka
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Corresponding author

Correspondence to Takuma Okamura.

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All authors declare that they have no conflict of interest.

Human/Animal Rights:

All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Informed consent was obtained from all patients for being included in the study.

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Okamura, T., Komatsu, M., Ito, A. et al. A case of acquired hemophilia A diagnosed after percutaneous endoscopic gastrostomy. Clin J Gastroenterol 8, 290–293 (2015). https://doi.org/10.1007/s12328-015-0601-z

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  • DOI: https://doi.org/10.1007/s12328-015-0601-z

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