Spontaneous Remission Of Refractory Anemia With Excess Of Blasts After Septicemia

Abstract

This is a presentation of a 41-year-old menstruating woman who developed evidence of circulating anticoagulants and was later found to have inhibitory qualities against factor VIII. She maintained this defect for a period of 5 years and had a spontaneous remission. During the course she had several life-threatening hemorrhages, either from blood loss or involvement in a vital area such as the chest, paratracheal region and intralumenal obstruction. Initially, a number of agents were given as a therapeutic trial, including steroids, all of which did not produce any significant alteration in her coagulation defect. With the judicious use of blood transfusions, mainly to replace lowered blood volume, she was able to maintain her same blood group and never developed a serious blood reaction. Her last serious illness was characterized by congestive heart failure, hypotension and at one point she was considered in extremis, but recovered and was discharged without evidence of recurrent bleeding. Her subsequent coagulation studies have now remained entirely normal as of this date.