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Acquired hemophilia

Authors: Kawtar Nassar;

Acquired hemophilia

Abstract

L'hémophilie acquise est une maladie rare de la coagulation, liée à la présence d'autoanticorps acquis dirigés contre le facteur VIII. Elle demeure idiopathique dans presque la moitié des cas. Diverses étiologies en sont responsables, notamment certaines maladies auto-immunes. Le diagnostic d'hémophilie acquise repose sur l'association d'un TCA isolément allongé et d'un déficit en facteur VIII lié à l'activité d'un anticorps (Ac) inhibiteur anti-VIII détecté par la méthode Bethesda. Il s'agit d'une urgence thérapeutique, compte tenu du risque de saignement chez certains cas. La stratégie thérapeutique de l'hémophilie acquise reste non consensuelle.Néanmoins, la prise en charge comprend deux objectifs ; le traitement des complications hémorragiques et l'éradication de l'inhibiteur. Un traitement immunomodulateur doit être instauré aussi rapidement que possible, et le pronostic est étroitement lié à la rapidité et à la qualité du traitement entrepris. En raison de la rareté de cette pathologie et de la diversité d'expression et d'évolution, l'objectif de notre article est de mettre le point sur cette affection, de la physiologie au traitement, à travers une revue de la littérature.

Acquired hemophilia is a rare coagulation, due to the presence of autoantibodies directed against acquired factor VIII. It remains idiopathic in almost half the cases, as in other cases, various etiologies are responsible, including some autoimmune diseases. The diagnosis of acquired hemophilia is based on the combination of a Time of cephalin activeted (TCA), and an extended isolation factor VIII deficiency related to the activity of an antibody anti-factor VIII inhibitor detected by the Bethesda method. It is a therapeutic emergency, given the severity of bleeding in some cases, due to its abundance and its seat. Therapeutic strategy of acquired hemophilia is non-consensual, but the support has two objectives; treatment of hemorrhagic complications and eradication of the inhibitor. Immunomodulatory therapy should be initiated as soon as possible, and the prognosis is closely related to the speed and quality of processing undertaken. Because of the rarity of this disease and the diversity of expression and evolution, the purpose of study is through a literature review to put the item of this disease, from physiology to treatment.

Keywords

Hémorragie,, Hémophilie acquise,, Immunosuppresseur,, Urgence thérapeutique.

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
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