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Acquired haemophilia and dental extractions - a cautionary tale

British Dental Journal volume 234, page 747 (2023)Cite this article

Haemophilia is an inherited bleeding disorder due to a deficiency in the coagulation factors VIII, IX or XI. Acquired haemophilia is caused by development of autoantibodies against the coagulation factors.1 It is a rare condition with an incidence of 1-6 cases per million, and is associated with a high mortality of between 7-38%, usually due to the risk of catastrophic bleeding.1,2 The peak age of incidence is >65 years, although a biphasic distribution has been reported.

Two days later, the patient presented to the emergency department (ED) with persistent bleeding from the extraction sockets. Upon examination, there was no active bleeding from the extraction sites and intra-oral sutures were in situ. The patient appeared well in themselves and was haemodynamically stable. However, a full blood count revealed a haemoglobin (Hb) level of 48 g/L (normal range 110-150 g/L). The patient gave a history of repeated visits to ED in the past six months due to recurrent epistaxis and had consequently received a blood transfusion. Their Hb was noted to be 75 g/L a month before the scheduled extractions.

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References

  1. Mingot-Castellano M E, Rodríguez-Martorell F J, Nuñez-Vázquez R J, Marco P. Acquired Haemophilia A: A review of what we know. J Blood Med 2022; 13: 691-710.

  2. Kessler C M, Knöbl P. Acquired haemophilia: An overview for clinical practice. Eur J Haematol 2015; 95: 36-44.

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  1. Royal Free London NHS Foundation Trust, London, United Kingdom

    Z. M. Zhou, S. Mumtaz & C. Jefferies

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  1. Z. M. Zhou
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  2. S. Mumtaz
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  3. C. Jefferies
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Correspondence to Z. M. Zhou, S. Mumtaz or C. Jefferies.

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Zhou, Z., Mumtaz, S. & Jefferies, C. Acquired haemophilia and dental extractions - a cautionary tale. Br Dent J 234, 747 (2023). https://doi.org/10.1038/s41415-023-5908-4

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  • DOI: https://doi.org/10.1038/s41415-023-5908-4

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