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An otherwise healthy 42-year-old man had hematuria and hematomas in both legs associated with a spontaneous inhibitor to factor VIII. The patient was treated with repeated plasma exchange, factor VIII concentrates, and steroids. Rapid clinical improvement with rapid recovery of circulating factor VIII occurred. Disappearance of the inhibitor was observed within 1 month. The patient remains well with no evidence of an inhibitor. It is unlikely that steroids were responsible for the disappearance of the inhibitor. Therefore, plasma exchange associated with factor VIII concentrate administration may be considered an effective tool for the management of patients with spontaneous idiopathic inhibitor to factor VIII.
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P Maisonneuve, and
A Bismuth, and
A Steg
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