RRML - Pitfalls in hemostasis exploration, a case report of a girl with Henoch-Schönlein type vasculitis

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Nr. 25(3)/2017 DOI:10.1515/rrlm-2017-0026

Case report

Pitfalls in hemostasis exploration, a case report of a girl with Henoch-Schönlein type vasculitis

Smaranda Arghirescu, Eugen Boia, Emilia Ursu, Delia Savescu, Madalina Boc, Cristian Jinca, Margit Serban

Correspondence should be addressed to: Margit Serban

Abstract:

The adequate performance and correct interpretation of assays for coagulation factor inhibitors play a critical role for the hemostasis laboratory. Both, false positive and false negative inhibitor assays may be reported, leading to erroneous patient’s management. Therefore, we decided to present a case with a spurious image of an exceptionally rare acquired combined haemophilia A, B and C, with severe factor (F) VIII, IX and XI deficiency, associated with high titre anti - F VIII, IX and XI inhibitors in a 4 years old girl with Henoch-Schönlein type vasculitis. Finally, performing, beside coagulometric methods also antigenic ELISA assays, we had to invalidate the diagnosis. The performance of antiphospholipd antibodies clarified the diagnosis , finally concluding as definite diagnosis Transient Lupus Anticoagulant Syndrome, with decisive impact on therapy and follow-up.

Keywords: acquired haemophilia, lupus anticoagulant, Henoch-Schönlein vasculitis, children, antiphospholipid antibody syndrome

Received: 4.5.2017
Accepted: 10.7.2017
Published: 10.7.2017

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Arghirescu S, Boia E, Ursu E, Savescu D, Boc M, Jinca C, et al. Pitfalls in hemostasis exploration, a case report of a girl with Henoch-Schönlein type vasculitis. Rev Romana Med Lab. 2017;25(3):295-300. DOI:10.1515/rrlm-2017-0026