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Findings that shed new light on the possible pathogenesis of a disease or an adverse effect
CASE REPORT
Development of acquired haemophilia A in a patient treated with alemtuzumab for multiple sclerosis
  1. Jarrett Madeley1,
  2. Georgina Hodges2,
  3. Andrew Birchley2
  1. 1Department of Haematology, Cairns Hospital, Cairns, Queensland, Australia
  2. 2Department of Haematology, Townsville Hospital, Townsville, Queensland, Australia
  1. Correspondence to Dr Jarrett Madeley, jarrett.madeley{at}gmail.com

Summary

This case illustrates a 36-year-old man who presented with a factor VIII (FVIII) inhibitor (acquired haemophilia A) with cutaneous bleeding and a significant thigh haematoma. No traditional risk factors for the development of a FVIII inhibitor were identified. However, previous treatment with alemtuzumab for multiple sclerosis was noted in the patient’s history. Alemtuzumab is an anti-CD52 monoclonal antibody and is known to be associated with the development of a number of autoimmune conditions, with a delay in onset of these conditions as long as 5 years after the cessation of treatment. To our knowledge, there have only been three previously documented cases of a FVIII inhibitor in the setting of alemtuzumab therapy. This case adds further evidence to the current body of literature suggesting alemtuzumab as a causative agent for the development of an FVIII inhibitor.

  • haematology (incl blood transfusion)
  • neurology
  • drugs: cns (not psychiatric)
  • multiple sclerosis

https://doi.org/10.1136/bcr-2018-226588

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    Footnotes

    • Contributors All listed authors provided significant contributions to the conception, design, acquisition, analysis and interpretation of the data. JM was responsible for the majority of drafting with input from GH and AB particularly for ongoing revisions. Final approval was given by all contributing authors for submission for publication. All listed authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of the work are appropriately investigated and resolved.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.