Partial Splenic Embolization in a Patient with Hemophilia A and Severe Thrombocytopenia: A Case Report

Author:

Nakamura Tomofumi12ORCID,Uchiba Mitsuhiro3,Nakata Hirotomo4,Mizumoto Takao5,Beppu Toru6ORCID,Matsushita Shuzo7

Affiliation:

1. Department of Hematology, Rheumatology, and Infectious Diseases, Graduate School of Medical Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan

2. Department of Laboratory Medicine, Kumamoto University Hospital, Kumamoto 860-8556, Japan

3. Department of Blood Transfusion and Cell Therapy, Kumamoto University Hospital, Kumamoto 860-8556, Japan

4. Department of Hematology, Rheumatology, and Infectious Diseases, Kumamoto University Hospital, Kumamoto 860-8556, Japan

5. Department of Surgery, National Hospital Organization Kumamoto Medical Center, Kumamoto 860-0008, Japan

6. Department of Surgery, Yamaga City Medical Center, Kumamoto 861-0501, Japan

7. Collaborative Research Program for Anti-Viral Agents and Hematological Diseases, Division of Clinical Retrovirology, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto 862-0973, Japan

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.

Publisher

MDPI AG

Reference25 articles.

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