Decrease in in vivo coagulant potential of emicizumab in a patient with hemophilia A and inhibitor complicated with infectious mononucleosis.
Humans
Antibodies, Bispecific
/ pharmacology
Coagulants
/ therapeutic use
Epstein-Barr Virus Infections
/ complications
Factor VIII
/ therapeutic use
Factor X
/ therapeutic use
Hemophilia A
/ complications
Hemorrhage
/ etiology
Herpesvirus 4, Human
Infectious Mononucleosis
/ complications
Clinical Trials, Phase I as Topic
Clinical Trials, Phase II as Topic
Male
Journal
Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis
ISSN: 1473-5733
Titre abrégé: Blood Coagul Fibrinolysis
Pays: England
ID NLM: 9102551
Informations de publication
Date de publication:
01 Mar 2023
01 Mar 2023
Historique:
entrez:
31
1
2023
pubmed:
1
2
2023
medline:
3
2
2023
Statut:
ppublish
Résumé
Emicizumab prophylaxis significantly reduces bleeding episodes in patients with hemophilia A (PwHA). There is little information on coagulant potentials in emicizumab-treated PwHA with infection, however. We encountered an emicizumab-treated PwHA with inhibitor, complicated with Epstein-Barr virus-associated infectious mononucleosis (IM) in phase 1/2 study (ACE001JP/ACE002JP). Although it was a typical clinical course of IM, activated partial thromboplastin time was mildly prolonged but rotational thromboelastometry revealed severely impaired coagulant potential. The blood concentration of emicizumab decreased moderately in the low concentration range, resulting in an increased risk of bleeding and possibly leading to severe ileocecal bleeds requiring coil embolization. The blood concentrations of factors IX/X little decreased and antiemicizumab antibodies did not develop, however. After the influence by IM resolved, his coagulant potentials gradually recovered with the recovery of emicizumab concentration, and parameters by global coagulation assays improved. An IM case for emicizumab-treated PwHA may need to monitor using global coagulation assays.
Identifiants
pubmed: 36719809
doi: 10.1097/MBC.0000000000001177
pii: 00001721-202303000-00007
doi:
Substances chimiques
Antibodies, Bispecific
0
Coagulants
0
emicizumab
7NL2E3F6K3
Factor VIII
9001-27-8
Factor X
9001-29-0
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
122-128Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
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