Acquired hemophilia a induced by clopidogrel
https://doi.org/10.35754/0234-5730-2026-71-2-188-201
Abstract
Introduction. Dual antiplatelet therapy (DATT) with aspirin and a platelet P2Y12 receptor inhibitor is one of the main components of treatment and secondary prevention in patients undergoing percutaneous coronary intervention in acute myocardial infarction. Among the side effects of DATT are hemorrhagic complications caused by the antiplatelet effect of the drugs. Less is known about hemorrhagic complications caused by coagulation disorders when taking clopidogrel.
Aim: to present a clinical case of acquired hemophilia A, which occurred in a patient as a result of taking clopidogrel.
Main findings. A 68-year-old patient received clopidogrel as part of DATT after percutaneous coronary intervention. One month later, he developed a pronounced hemorrhagic syndrome caused by the appearance of antibodies to coagulation factor VIII (FVIII:C 1.5 %, factor VIII inhibitor 61 BU). The elimination of clopidogrel, hemostatic therapy with eptacog alpha (activated) and immunosuppressive therapy with prednisone, cyclophosphamide and rituximab allowed not only to stop the hemorrhagic syndrome, but also to achieve eradication of the inhibitor.
About the Authors
G. M. Galstyan
National Medical Research Center for Hematology; National Medical Research Center for Obstetrics, Gynecology and Perinatology
Russian Federation
Russian Federation
Gennadiy M. Galstyan, Dr. Sci. (Med.), Head of the Resuscitation and Intensive Care Department; Professor of Department of Anesthesiology and Intensive Care
125167, Moscow
117997, Moscow
D. Yu. Kostyuk
National Medical Research Center for Hematology
Russian Federation
Russian Federation
Daria Yu. Kostyuk, Postgraduate Student, Resuscitation and Intensive Care Department
125167, Moscow
S. Yu. Mamleeva
National Medical Research Center for Hematology
Russian Federation
Russian Federation
Svetlana Yu. Mamleeva, Head of Express-Laboratory
125167, Moscow
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For citations:
Galstyan G.M., Kostyuk D.Yu., Mamleeva S.Yu. Acquired hemophilia a induced by clopidogrel. Russian journal of hematology and transfusiology. 2026;71(2):188-201. (In Russ.) https://doi.org/10.35754/0234-5730-2026-71-2-188-201
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