Protein A sepharose immunoadsorption: immunological and haemostatic effects in two cases of acquired haemophilia |
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Authors: | Guillet B Kriaa F Huysse M G Proulle V George C Tchernia G D'Oiron R Laurian Y Charpentier B Lambert T Dreyfus M |
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Institution: | Laboratoire d'Hématologie et Centre de Référence et de Traitement de l'Hémophilie, H?pital Bicêtre, AP-HP et Faculté de Médecine Paris XI, 94275 Le Kremlin-Bicêtre, Paris, France. |
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Abstract: | Acquired haemophilia is a life-threatening disorder caused by circulating auto-antibodies that inhibit factor VIII coagulant activity (FBIII:C). Immunoadsorption on protein A sepharose (IA-PA) was performed in two bleeding patients with acquired haemophilia: we observed a dramatic and quick decrease in the anti-FVIII:C inhibitor titre leading to a normal, albeit transient, haemostatic status. In one case, IA-PA was the only procedure which succeeded in stopping massive haemorrhage. In the second case, IA-PA reinforced the haemostatic effect of recombinant activated factor VII by increasing the endogenous plasma factor VIII level. The efficacy of IA-PA was sustained with immunosuppressive treatment introduced, respectively, 10 and 15 d before the IA-PA procedures. Our experience with IA-PA suggests that this extracorporeal anti-FVIII:C removal procedure is a valuable therapeutic tool for acquired haemophilia and can alleviate life-threatening haemorrhages. |
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Keywords: | acquired haemophilia anti-FVIII:C inhibitor immunoadsorption on protein A sepharose |
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