Hemofilia A adquirida secundaria a un carcinoma urotelial : reporte de caso.
Acquired haemophilia A, secondary to urothelial carcinoma : a case report.
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La hemofilia adquirida es un trastorno de difícil diagnóstico, poco prevalente, con una edad de aparición bifásica. En el 40-50% de los casos suele existir una causa subyacente. Se presenta el caso de un paciente de 79 años con equimosis atraumáticas generalizadas y hematuria de dos meses de evolución. Se documentó TTPa prolongado con TP normal, factor VIII (0,3%) y IX (53,1%); título de inhibidores contra factor VIII de 48U Bethesda. Inició manejo con complejo coagulante antiinhibidor asociado a ciclofosfamida y prednisolona. Se documentó carcinoma urotelial de bajo grado que se resecó, posterior a lo cual se logró control del sangrado, normalización de los niveles de factor VIII y desaparición del inhibidor.
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