POSTPARTUM FACTOR-VIII INHIBITORS - REPORT OF 2 CASES WITH SPECIAL REFERENCE TO THE EFFICACY OF VARIOUS TREATMENTS

Two cases of postpartum inhibitors to F VIII are described. One patien t had a severe bleeding tendency (iliopsoas bleeding, forearm bleeding ). The maximum inhibitor titer was 800 BU/ml in case 1 and 120 BU/ml i n case 2. Bleeding was controlled by treatment with human and porcine factor VIII concentrate and with activated prothrombin complex concent rate (FEIBA(R), Immuno AG, Vienna, Austria) in case 1, while no replac ement therapy was given in case2. Prednisone (given in both cases) and high-dose immunoglobulin (given in case 2) was without effect. Cyclop hosphamide (100 mg per day), combined with small doses of prednisone l ed to complete disappearance of the inhibitor and normalization of fac tor VIII in case 1. In the other patient who refused treatment with cy clophosphamide the inhibitor titer remained high over a period of 13 m onths.