Acquired Hemophilia [antikvár]

Autoantibodies directed against each of the coagulation factors have been described, however, those directed against factor VIII (FVIII) are by far the most common.14 They share several features in common with the FVIII antibodies seen in hemophiliacs (eg, the autoantibodies are primarily of the IgG class, with IgG4 heavy chains, and are directed against FVIII procoagulant activity rarely interfering with other functions of the FVIII molecule). However, there are many differences as well, including degree of antibody heterogeneity, reaction kinetics between inhibitor and FVIII,2 patient demographics, type and severity of bleeding, natural history, and therapeutic considerations. In contrast to the inhibitors which develop in 15 to 25% of predominantly young persons with severe hemophilia A,5-10 those seen in non-hemophiliacs occur predominantly in adults, including pregnant or postpartum women, older adults with no apparent underlying disease, or in persons with various immunologic disorders such as systemic lupus erythematosus, rheumatoid l