Letter to the Editor
Acquired haemophilia A secondary to metastatic prostate cancer
Hemofilia A adquirida secundaria a cáncer de próstata metastásico
Read
2
Timeswas read the article
2
Total PDF
0
Total HTML
Share statistics
array:24 [ "pii" => "S2387020622002704" "issn" => "23870206" "doi" => "10.1016/j.medcle.2022.05.011" "estado" => "S300" "fechaPublicacion" => "2022-06-24" "aid" => "5901" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2022" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2022;158:e19-e20" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0025775322000392" "issn" => "00257753" "doi" => "10.1016/j.medcli.2021.12.016" "estado" => "S300" "fechaPublicacion" => "2022-06-24" "aid" => "5901" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2022;158:e19-e20" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Editor</span>" "titulo" => "Hemofilia A adquirida secundaria a cáncer de próstata metastásico" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e19" "paginaFinal" => "e20" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Acquired haemophilia A secondary to metastatic prostate cancer" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Alejandro Olivares-Hernández, Luis Figuero-Pérez, Emilio Fonseca-Sánchez" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Alejandro" "apellidos" => "Olivares-Hernández" ] 1 => array:2 [ "nombre" => "Luis" "apellidos" => "Figuero-Pérez" ] 2 => array:2 [ "nombre" => "Emilio" "apellidos" => "Fonseca-Sánchez" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2387020622002704" "doi" => "10.1016/j.medcle.2022.05.011" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020622002704?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775322000392?idApp=UINPBA00004N" "url" => "/00257753/0000015800000012/v2_202206152104/S0025775322000392/v2_202206152104/es/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S2387020622002716" "issn" => "23870206" "doi" => "10.1016/j.medcle.2022.01.008" "estado" => "S300" "fechaPublicacion" => "2022-06-24" "aid" => "5914" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Clin. 2022;158:633" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in medicine</span>" "titulo" => "Osteochondroplastic tracheobronchopathy" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "633" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Traqueobroncopatía osteocondroplástica" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 645 "Ancho" => 805 "Tamanyo" => 85222 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Jorge Rodríguez-Sanz, Olalla García Rodríguez, David Guallar García, María Aguado Agudo, Elisa Minchole Lapuente" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Jorge" "apellidos" => "Rodríguez-Sanz" ] 1 => array:2 [ "nombre" => "Olalla" "apellidos" => "García Rodríguez" ] 2 => array:2 [ "nombre" => "David" "apellidos" => "Guallar García" ] 3 => array:2 [ "nombre" => "María" "apellidos" => "Aguado Agudo" ] 4 => array:2 [ "nombre" => "Elisa" "apellidos" => "Minchole Lapuente" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020622002716?idApp=UINPBA00004N" "url" => "/23870206/0000015800000012/v1_202206230718/S2387020622002716/v1_202206230718/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2387020622002790" "issn" => "23870206" "doi" => "10.1016/j.medcle.2021.12.007" "estado" => "S300" "fechaPublicacion" => "2022-06-24" "aid" => "5889" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2022;158:e17-e18" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Hypovitaminosis C as an unexpected cause of bleeding in a cirrhotic patient" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e17" "paginaFinal" => "e18" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hipovitaminosis C como causa inesperada de hemorragia en un paciente con cirrosis hepática" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Miguel Sogbe, Mercedes Iñarrairaegui, Félix Alegre" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Miguel" "apellidos" => "Sogbe" ] 1 => array:2 [ "nombre" => "Mercedes" "apellidos" => "Iñarrairaegui" ] 2 => array:2 [ "nombre" => "Félix" "apellidos" => "Alegre" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020622002790?idApp=UINPBA00004N" "url" => "/23870206/0000015800000012/v1_202206230718/S2387020622002790/v1_202206230718/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Acquired haemophilia A secondary to metastatic prostate cancer" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e19" "paginaFinal" => "e20" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Alejandro Olivares-Hernández, Luis Figuero-Pérez, Emilio Fonseca-Sánchez" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Alejandro" "apellidos" => "Olivares-Hernández" "email" => array:1 [ 0 => "aolivares@saludcastillayleon.es" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Luis" "apellidos" => "Figuero-Pérez" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Emilio" "apellidos" => "Fonseca-Sánchez" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Oncología Médica, Hospital Universitario de Salamanca, Salamanca, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Facultad de Medicina, Universidad de Salamanca, Salamanca, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hemofilia A adquirida secundaria a cáncer de próstata metastásico" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Acquired haemophilia (AH) is a rare autoimmune disorder characterised by the production of autoantibodies that inactivate clotting factors, with the most common being factor <span class="elsevierStyleSmallCaps">VIII</span> (FVIII) inhibitor. The incidence of this disease varies between 1–2 cases per million inhabitants/year. There is a first age peak among young women during the postpartum period and another at 60 years of age.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The typical clinical manifestations of the acquired form are mucocutaneous and muscle bleeding, unlike the congenital form in which hemarthrosis is the most common form of presentation.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> The most common causes are autoimmune diseases, pregnancy and neoplasms, although 50% are idiopathic. The treatment consists of 2 differentiated parts: one aimed at correcting the bleeding episodes and one aimed at controlling autoantibodies. Mortality is very high, ranging between 7 and 22%. We report the case of a 67-year-old patient who developed acquired haemophilia A secondary to metastatic castration-resistant prostate cancer (mCRPC) in the context of the article by Dr. Páramo,<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> in which new haemophilia treatments with potential future implications for AH are discussed.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The patient was diagnosed in 2016 with prostate cancer (Gleason 4 + 5) stage <span class="elsevierStyleSmallCaps">IV</span> due to bone involvement. Following the diagnosis, he underwent various treatments such as complete androgen blockade with docetaxel, radium-223 and abiraterone, which he was receiving at the time of AH development. He came to the emergency department with multiple haematomas predominantly in the parotid and cervical region, with no associated trauma. The blood test at the emergency department showed haemoglobin values of 9.4 g/dl and activated partial thromboplastin time (aPTT) of 101.6 s. In the aPTT study, the factors of the intrinsic pathway were quantified by coagulative method, with a FVIII:C = 1.54%. The presence of lupus anticoagulant was ruled out. Factor VIII inhibitor titres were found to be elevated using the Bethesda method. That is why the patient was diagnosed with acquired hemophilia A secondary to mCRPC.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Inpatient treatment with prednisone and cyclophosphamide was started, as well as treatment of his underlying disease with docetaxel. A few days later, the patient developed a joint bleeding that required the administration of recombinant activated factor <span class="elsevierStyleSmallCaps">VII</span> (rFVIIa), with good subsequent control. After the second cycle of chemotherapy, a decrease in inhibitory factor values and an increase in FVIII:C, up to 46%, were observed, for which treatment with cyclophosphamide and glucocorticoids was withdrawn. The patient remained hospitalized until he received a total of 4 cycles of chemotherapy and was discharged after the stabilization of FVIII:C levels.</p><p id="par0020" class="elsevierStylePara elsevierViewall">10% of AH are due to malignant neoplasms, mainly solid tumours of the prostate, lung or colon.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> In most cases, the diagnosis of AH precedes or occurs at the same time as that of neoplasm. Due to the rare condition of the disease, the diagnosis is complex, requiring a high degree of suspicion. Initial laboratory tests usually show an elongated aPTT, a normal platelet count and decreased FVIII or FIX levels. It is important to rule out the use of oral anticoagulants, heparins or liver function disorders in the differential diagnosis. To confirm the diagnosis, clinical practice guidelines recommend testing for the absence of antiphospholipid antibodies and confirming the presence of clotting factor inhibitor in the patients’ plasma.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> All these causes of AH have been ruled out in the differential diagnosis of our patient.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Treatment of the underlying malignancy has not been shown to influence the control of HA and the disappearance of inhibitory factor titres, however, in our patient’s case, by initiating a new line of treatment, remission of inhibitory factor titres was possible. This is why, in addition to treatment of the underlying disease, new lines of research with other treatments such as new clotting factors, non-substitutive drugs or gene therapy will be necessary in the future.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0030" class="elsevierStylePara elsevierViewall">None.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interests</span><p id="par0035" class="elsevierStylePara elsevierViewall">None to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflict of interests" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Olivares-Hernández A, Figuero-Pérez L, Fonseca-Sánchez E. Hemofilia A adquirida secundaria a cáncer de próstata metastásico. Med Clin (Barc). 2022;158:e19–e20.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acquired haemophilia in cancer: a systematic and critical literature review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Napolitano" 1 => "S. Siragusa" 2 => "S. Mancuso" 3 => "C.M. Kessler" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/hae.13355" "Revista" => array:6 [ "tituloSerie" => "Haemophilia" "fecha" => "2018" "volumen" => "24" "paginaInicial" => "43" "paginaFinal" => "56" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28960809" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acquired haemophilia A: updated review of evidence and treatment guidance" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Kruse-Jarres" 1 => "C.L. Kempton" 2 => "F. Baudo" 3 => "P.W. Collins" 4 => "P. Knoebl" 5 => "C.A. Leissinger" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/ajh.24777" "Revista" => array:6 [ "tituloSerie" => "Am J Hematol" "fecha" => "2017" "volumen" => "92" "paginaInicial" => "695" "paginaFinal" => "705" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28470674" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of haemophilia: from replacement to gene therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.A. Páramo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Clin (Barc)" "fecha" => "2021" "volumen" => "157" "paginaInicial" => "583" "paginaFinal" => "587" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Life-threatening hemorrhage from acquired hemophilia A as a presenting manifestation of prostate cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. Sheth" 1 => "A. Gill" 2 => "S. Sekhon" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "J Community Hosp Intern Med Perspect" "fecha" => "2016" "volumen" => "76" "paginaInicial" => "32461" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acquired haemophilia: an overview for clinical practice" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.M. Kessler" 1 => "P. Knöbl" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/ejh.12689" "Revista" => array:6 [ "tituloSerie" => "Eur J Haematol" "fecha" => "2015" "volumen" => "95" "paginaInicial" => "36" "paginaFinal" => "44" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26679396" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015800000012/v1_202206230718/S2387020622002704/v1_202206230718/en/main.assets" "Apartado" => array:4 [ "identificador" => "43309" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015800000012/v1_202206230718/S2387020622002704/v1_202206230718/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020622002704?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2023 March | 0 | 2 | 2 |
