Successful treatment of acquired hemophilia A, complicated by chronic GVHD, with tocilizumab

Vol.21 No.4

Case Report

Successful treatment of acquired hemophilia A, complicated by chronic GVHD, with tocilizumab

Authors

Sumiyuki Nishida¹ , Tomio Kawasaki² , Hirokazu Kashiwagi³ , Atsuyoshi Morishima¹ , Yoshihiro Hishitani¹ , Mari Kawai¹ , Toru Hirano¹ , Taeko Ishii¹ , Keisuke Hagihara¹ , Yoshihito Shima¹ , Masashi Narazaki¹ , Atsushi Ogata¹, Yoshihiro Oka¹, Tadamitsu Kishimoto⁴, Toshio Tanaka¹

Department of Respiratory Medicine, Allergy and Rheumatic Diseases, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita Osaka, 565-0871, Japan
Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
Laboratory of Immune Regulation, Osaka University Graduate School of Frontier Biosciences, Suita, Osaka, Japan

Received:

3 December 2010

Accepted:

18 December 2010

Published online:

15 January 2011

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Abstract

A 65-year-old woman who had suffered from chronic graft-versus-host disease (GVHD) presented with extensive purpura and was diagnosed with acquired hemophilia A. Because she was refractory to corticosteroids and her condition was complicated with diabetes mellitus, glaucoma, and hypoglobulinemia, she was treated with tocilizumab. Tocilizumab treatment increased the activity of factor VIII in a rapid and sustained manner, leading to a reduction of the prednisolone dose. Tocilizumab may thus be an optional treatment modality for acquired hemophilia A.

Key words

Acquired hemophilia A - Inhibitors - Factor VIII - IL-6 - Tocilizumab