PDF(Pubmed)
Abstract：
We report a patient with hemophilia A who underwent partial splenic embolization (PSE) for severe thrombocytopenia secondary to portal hypertension-induced splenomegaly, resulting in a stable long-term quality of life. The patient was diagnosed with hemophilia A and unfortunately contracted human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) from blood products. He subsequently developed progressive splenomegaly due to portal hypertension from chronic HCV, resulting in severe thrombocytopenia. PSE was performed because he had occasional subcutaneous bleeding and needed to start interferon (IFN) and ribavirin (RBV) treatment for curing his HCV infection at that time. His platelet counts increased, and no serious adverse events were observed. Currently, he continues to receive outpatient treatment, regular factor VIII (FVIII) replacement therapy for hemophilia A, and antiretroviral therapy for HIV infection. Vascular embolization has been reported to be an effective and minimally invasive treatment for bleeding in hemophilia patients. PSE also provided him with a stable quality of life without the side effects of serious infections and thrombocytopenia relapses. We conclude that PSE is a promising therapeutic option for patients with hemophilia A.
摘要：
我们报告了一名血友病A患者，因门脉高压引起的脾肿大继发的严重血小板减少症，接受了部分脾栓塞术（PSE）。带来稳定的长期生活质量。患者被诊断为A型血友病，不幸感染了人类免疫缺陷病毒（HIV），乙型肝炎病毒（HBV），和来自血液制品的丙型肝炎病毒（HCV）。他随后由于慢性HCV门脉高压而发展为进行性脾肿大，导致严重的血小板减少症。进行PSE是因为他偶尔有皮下出血，当时需要开始干扰素（IFN）和利巴韦林（RBV）治疗以治愈他的HCV感染。他的血小板计数增加了,未观察到严重不良事件.目前,他继续接受门诊治疗，血友病A的常规因子VIII（FVIII）替代疗法，和抗逆转录病毒治疗HIV感染。据报道，血管栓塞是血友病患者出血的有效和微创治疗方法。PSE还为他提供了稳定的生活质量，没有严重感染和血小板减少症复发的副作用。我们得出结论，PSE是血友病A患者的有希望的治疗选择。
