| 1 | Acquired haemophilia in patients with malignant disease:A case report显示文摘BACKGROUND Acquired haemophilia is a rare coagulation disorder characterized by autoantibodies against coagulation factor VIII leading to severe and potentially life-threatening haemorrhages.The underlying disorder causing the development of an autoimmune phenomenon is not always known,but 10%-15%could be linked to malignancies.Patients with cancer who require surgical resection represent a treatment challenge not solely due to increased risk of bleeding but also due to adverse events of immunosuppressive therapy.CASE SUMMARY We present the case of a 67-year-old man with non-metastatic adenocarcinoma of the distal bile duct who developed concomitant acquired haemophilia a month after having been diagnosed with malignant disease.Haemostasis was established with recombinant activated factor VII,and immunosuppressive therapy was started immediately.An extensive surgical procedure was performed in order to remove the cancer and,therefore,eliminate the inhibitory autoantibodies.Due to a complicated postoperative course,relatively short period of treatment and likelihood of micrometastases,no improvement in the patient’s status was observed.Diagnosis and treatment of acquired haemophilia as well as other coagulation disorders in patients with cancer are discussed.CONCLUSION Prompt diagnosis of acquired haemophilia is required in order to start appropriate treatment and reduce mortality.Among patients with cancer,other causes of abnormal bleeding related to malignancy should be considered. | Veronika Krašek Aleša Kotnik Hana Zavrtanik Jasna Klen Samo Zver | 2021 | World Journal of Clinical Cases2021，9，10： | 0 |
| 2 | Wells’syndrome possibly caused by hematologic malignancy,influenza vaccination or ibrutinib:A case report显示文摘BACKGROUND Wells’ syndrome(eosinophilic cellulitis) is an uncommon eosinophilic dermatosis of uncertain pathogenesis,characterized by clinical polymorphism and suggestive but nonspecific histopathologic traits.Its course is recurrent,and response to therapy is unpredictable.In a case in which the patient has a number of potential triggers for the manifestation of Wells’ syndrome skin rash,the treating physician must decide or must make an assumption in order to establish the most likely clinical scenario.This is important for the patient’s future treatment plans.CASE SUMMARY We describe the clinical case of a 46-year-old female with chronic lymphocytic leukemia who had already received treatment for several months with ibrutinib.She was diagnosed with Wells’ syndrome 10 d after an influenza vaccination containing thimerosal.Based on the literature,the patient was treated with a course of oral steroids.Resolution of clinical symptoms and rash were observed in response to the treatment.Ibrutinib was not discontinued.CONCLUSION The etiology of Wells’ syndrome remains unknown.Clinically,it resembles bacterial cellulitis.Lack of response to antibiotic treatment should lead the physician to consider a diagnosis of Wells’ syndrome.Treating the underlying condition is important and may lead to resolution of the syndrome.However,the most common and effective treatment to limit the course of the disease are systemic steroids. | Mihela Šajn Boštjan Luzar Samo Zver | 2022 | World Journal of Clinical Cases2022，10，30： | 0 |
您所在的机构暂未开通此部分的功能，请联系管理员