Resumen La
hemofilia adquirida es una complicación rara y potencialmente fatal en
pacientes con
neoplasias hematológicas (desórdenes linfoproliferativos) o
tumores sólidos. Presentamos una
paciente de 75 años de
sexo femenino con antecedente de
hipertensión arterial y
anemia ferropénica que ingresa a
urgencias por cuadro de
dolor abdominal generalizado tipo
cólico , asociado a episodios
eméticos de contenido alimentario y deposiciones melénicas. Dentro de los estudios iniciales se encontraron tiempos de
coagulación prolongados, prueba de mezclas de aPTT con evidencia de
anticoagulante circulante específico,
factor IX , 0% y
factor VIII , 0% con inhibidores de
factor VIII y IX en 180 UB y 130 UB respectivamente. Se consideró que la
paciente cursaba con
hemofilia adquirida A y B con realización de estudios de extensión diagnosticándose
linfoma no Hodgkin marginal esplénico.
Abstract Acquired
hemophilia is a potentially fatal rare complication of
patients with
hematological malignancies (usually
lymphoproliferative disorders ) or solid
tumors . We
report a 75-year
female patient with a
history of arterial
hypertension and
iron deficiency anemia . Log in to the
emergency department complaining of generalized cramping
abdominal pain associated with
emetic episodes and melenic stools. In initial studies found
prothrombin time (PT) 19 seconds control 11 seconds,
INR 1.8 and
activated partial thromboplastin time (aPTT) 45 seconds, control 29 seconds. Mixing aPTT study with normal
plasma was performed suggesting specific anticoagulation factor. Other tests were performed
Factor IX 0%,
factor VIII and 0%.
Factor VIII inhibitor 180 UB,
factor IX inhibitor 130 UB. It was considered acquired
hemophilia A and B and was studying with extension studies found a splenic marginal non Hodgkin lymphoma.