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Elimination von erworbenen Gerinnungsinhibitoren mit extrakorporaler Immunadsorption (Ig-Therasorb)

  • Conference paper
27. Hämophilie-Symposion Hamburg 1996

Zusammenfassung

Die Bildung von Antikörpern gegen die Gerinnungsfaktoren VIII und IX stellt ein bekanntes Problem bei der Behandlung von Patienten mit Hämophilie dar [1]. Solche Antikörper können jedoch auch spontan bei Patienten mit ursprünglich normaler Blutgerinnung auftreten [2]. Weitere erworbene Gerinnungsinhibitoren, die sich klinisch in schwerer Blutungsneigung äußern können und deren Inzidenz in den letzten Jahren (durch den zunehmenden Einsatz von Fibrinklebern) zunimmt, sind gegen die Faktoren II und V gerichtet [3]. Spontane Gerinnungsinhibitoren wurden bei Patienten mit Autoimmunerkrankungen, Malignomen oder Paraproteinämien gefunden, sie können auch postpartal auftreten oder durch Medikamente oder Blutprodukte induziert werden. In der Mehrzahl der Fälle kann jedoch keine zugrundeliegende Ursache identifiziert werden [4].

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Literatur

  1. Briet E, Rosendaal FR, Kreuz W, Rasi V, Peerlinck K, Vermylen J, Ljung R, Rocino A, Addiego J, Lorenzo JI, Pabinger I (1994) High titer inhibitors in severe haemophilia A. A metaanalysis based on eight long-term follow-up studies concerning inhibitors associated with crude or intermediate purity factor VIII products. Thromb Haemost 72: 162–164

    Google Scholar 

  2. Green D, Lechner K (1981) A survey of 215 non-hemophilic patients with inhibitors to factor VIII. Thromb Haemost 45: 200–203

    PubMed  CAS  Google Scholar 

  3. Knöbl P, Tribl B, Lechner K (1996) Erworbene Faktor V Inhibitoren. Hämostaseologie 16: 180–187

    Google Scholar 

  4. Feinstein DI (1994) Immune coagulation disorders. In: Colman RW, Hirsh J, Marder VJ, Salzman EW (eds) Hemostasis and Thrombosis. Lippincott Comp., Philadelphia, ISBN 0397–51059–4, pp 881 – 905

    Google Scholar 

  5. Nilsson IM, Berntorp E, Freiburghaus C (1993) Treatment of patients with factor VIII and IX inhibitors. Thromb Haemost 70: 56–59

    PubMed  CAS  Google Scholar 

  6. Francesconi M, Korninger C, Thaler E, Niessner H, Hocker P, Lechner K (1982) Plasmapheresis: its value in the management of patients with antibodies to factor VIII. Haemostasis 11: 79–85

    PubMed  CAS  Google Scholar 

  7. DuMoulin A, Müller-Derlich J, Bieber F, Richter WO, Frei U, Müller R, Spaethe R (1993) Antibody Based Immunoadsorption as a Therapeutic Means. Blood Purif 11: 145–149

    Article  CAS  Google Scholar 

  8. Graninger W, Druml W, Derfler K. IgG-apheresis in severe life-threatening lupus erythematosus. Manuscript in preparation

    Google Scholar 

  9. Derfler K, Swoboda K, Hirschl MM, Gottsauner-Wolf M, Steger G, Sunder-Plassmann G, Widhalm K (1992) Comparison of plasmaseparation and immunospecific LDL elimination in severe hypercholesterolemia. Int J Artificial Organs 15: 307–308

    Google Scholar 

  10. Diem K, Mayr W, Sautner T, Mühlbacher F, Hörl W, Jansen M, Druml W, Derfler K (1995) Anti-HLA antibody removal by IgG immunoapheresis in highly sensitized renal transplant recipients. J Am Soc Nephrol 6: 1080a

    Google Scholar 

  11. Knöbl P, Derfler K, Korninger L, Kapiotis S, Jäger U, Maier-Dobersberger T, Hörl W, Lechner K, Pabinger I (1995) Elimination of acquired factor VIII antibodies by extracorporal antibody-based immunoadsorption ( Ig-Therasorb ). Thromb Haemost 74: 1035–1038

    Google Scholar 

  12. Tribl B, Knöbl P, Derfler K, Kapiotis S, Aspöck G, Jäger U, Hörl W, Lechner K (1995) Rapid elimination of a high titer spontaneous factor V antibody by extracorporal antibody-based immunoadsorption and immunosuppression. Ann Haematol 71: 199–203

    Article  CAS  Google Scholar 

  13. Nilsson IM, Berntorp E, Zettervall 0 (1988) Induction of immune tolerance in patients with hemophilia and antibodies to factor VIII by combined treatment with intravenous IgG, cyclophosphamide, and factor VIII. N Engl J Med 318: 47–50

    Google Scholar 

  14. Nilsson IM, Jonsson S, Sundqvist SB, Ahlberg A, Bergentz SE (1981) A procedure for removing high titer antibodies by extracorporeal protein A sepharose adsorption in hemophilia. Blood 58: 38–42

    PubMed  CAS  Google Scholar 

  15. Freedman J, Semple JW, Teitel J, Stewart K, Garvey B (1992) Clinical and immunologic effects of staphylococcal protein A immunoadsorption therapy for inhibitor to factor VIII. Transfus Sci 13: 223–32

    Article  Google Scholar 

  16. Nilsson IM, Sundqvist SB, Freiburghaus C (1983) Extracorporeal protein A sepharose and specific affinity chromatography for removal of antibodies. In: Hoyer LW (ed) Factor VIII inhibitors. Liss Inc, New York, pp 225–241

    Google Scholar 

  17. Snyder HW, Cochran SK, Balint JP, Bertram JH, Mittelman A, Guthrie TH, Jones FR (1992) Experience with protein A–immunoadsorption in treatment-resistant adult immune thrombocytopenic purpure. Blood 79: 2237–2345

    PubMed  Google Scholar 

  18. Christie DJ, Howe RB, Lennon SS, Sauro SC (1993) Treatment of refractoriness to platelet transfusion by protein A column therapy. Transfusion 33: 234–242

    Article  PubMed  CAS  Google Scholar 

  19. Käbisch A, Kroll H, Wedi B, Kiefel V, Pralle H, Müller-Eckhardt C (1994) Severe adverse effects of protein A immunoadsorption. Lancet 343: 116

    Article  PubMed  Google Scholar 

  20. Hoyer LW, Gawryl MS, de la Fuente B (1983) Immunochemical characterization of factor VIII inhibitors. In: Hoyer LW (ed) Factor VIII inhibitors. Liss Inc, New York, pp 73–85

    Google Scholar 

  21. Glueck HI, Hong R (1965) A circulating anticoagulant in GGG1A-multiple myeloma: Its modification by penicillin. J Clin Invest 44: 1866–1881

    Google Scholar 

  22. Lane TA, Shapira SS, Burka ER (1978) Factor V antibody and disseminated intravascular coagulation. Ann Int Med 89: 182–185

    PubMed  CAS  Google Scholar 

  23. Crowell EB (1975) Observations on a factor V inhibitor. Br J Haematol 29: 397–404

    Article  PubMed  Google Scholar 

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Authors
  1. P. Knöbl
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  2. K. Derfler
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  3. I. Pabinger
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  4. K. Lechner
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Editor information

Editors and Affiliations

  1. Zentr. d. Inn. Med., Med. Klinik I, Universitätsklinikum, Theodor-Stern-Kai 7, D-60590, Frankfurt am Main, Deutschland

    Inge Scharrer

  2. Hämostaseologische Abteilung, Med. Univ.-Klinik Innenstadt, Ziemssenstraße 1a, D-80336, München, Deutschland

    Wolfgang Schramm

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© 1998 Springer-Verlag Berlin Heidelberg

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Knöbl, P., Derfler, K., Pabinger, I., Lechner, K. (1998). Elimination von erworbenen Gerinnungsinhibitoren mit extrakorporaler Immunadsorption (Ig-Therasorb). In: Scharrer, I., Schramm, W. (eds) 27. Hämophilie-Symposion Hamburg 1996. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-80403-8_13

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  • DOI: https://doi.org/10.1007/978-3-642-80403-8_13

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-62915-3

  • Online ISBN: 978-3-642-80403-8

  • eBook Packages: Springer Book Archive

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