PMC6319692_01
Trends of (a) activated partial thromboplastin time (aPTT), (b) factor VIII level and inhibitor titer, (c) platelet and absolute neutrophil count (ANC) and therapeutic interventions.
fig-1.jpg
PMC6319692_01_fig-1.jpg
f1
Specific tests such as lupus anticoagulant, dilute Russel viper venom test, thrombin time, and other coagulation factors were within normal limits (Fig. 1 and Table 1). The inhibitor titer peaked at 243.9 BU and factor VIII at nadir was <1% (Fig. 1). The factor VIII levels improved to 13% and inhibitor titer decremented to <0.6 BU (Fig. 1). As RBC and WBC counts were stable, he was initiated on IVIG for ITP, resulting in normalization of platelet count (Fig. 1). The steroid dose was increased to 60 mg daily, cyclophosphamide stopped, and granulocyte-colony stimulating factor (G-CSF) initiated (daily for four doses), with prompt recovery of WBC counts (Fig. 1).