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Exsanguinating bleeding following tooth extraction in a 12-year-old girl: a rare case of acquired haemophilia A

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Acquired haemophilia A (AHA) is a life-threatening haemorrhagic disorder that occurs with various underlying conditions such as autoimmune disease, drug reactions, lymphoproliferative diseases, solid tumours and pregnancy/postpartum status. However, in half of all reported cases, the underlying disease is unknown. Most AHA cases develop in adults; paediatric/adolescent cases are extremely rare. The main clinical symptom is bleeding into the skin, muscles, soft tissues and/or mucous membranes. Here, we report the case of an otherwise healthy 12-year-old girl who presented with prolonged bleeding postexodontia. After being diagnosed with AHA, she was successfully treated with recombinant activated factor VII infusion and oral prednisolone. To avoid such unanticipated bleeding when performing dental extraction, preoperative haemostatic screening tests are recommended.
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Keywords: acquired haemophilia A; adolescence; recombinant activated factor VII; tooth extraction

Document Type: Research Article

Affiliations: 1: Department of Pediatrics, Kyoto Second Red Cross Hospital, Kyoto 2: Department of Regulatory Medicine for Thrombosis 3: Department of Pediatrics, Nara Medical University, Nara 4: Department of Pediatrics, Kyoto Prefectural University of Medicine 5: Division of Laboratory Medicine, Uji Tokushukai Medical Center, Kyoto, Japan

Publication date: December 1, 2015

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