https://doi.org/10.4081/ecj.2022.10457
An unexpected turn of events: A rare case of Acquired Haemophilia A after a violin spider bite
Submitted: 13 March 2022
Accepted: 19 May 2022
Published: 27 June 2022
Accepted: 19 May 2022
Abstract Views: 940
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
We report an interesting clinical case of Acquired Haemophilia A (AHA) after a probable Loxosceles rufescens spider bite in a 73- year-old woman, admitted to an Emergency Department (ED) of Central Italy during April 2019. AHA is a rare disease, whose acute clinical manifestations are not widely known by most ED physicians; its prompt recognition and treatment are crucial to avoid fatal bleeding. In particular, the development of AHA after a violin spider bite (another rare and poorly characterized clinical condition) has never been described. Therefore, our case report could provide useful insight into the understanding and treatment of such unusual and possibly life-threatening conditions.
Nentwig W, Pantini P, Vetter RS. Distribution and medical aspects of Loxosceles rufescens, one of the most invasive spiders of the world (Araneae: Sicariidae). Toxicon 2017;132:19-28.
DOI: https://doi.org/10.1016/j.toxicon.2017.04.007
Jerusalem K, Salavert M. Probable cutaneous loxoscelism with mild systemic symptoms : A case report from Spain. Toxicon 2018;156:7-12.
DOI: https://doi.org/10.1016/j.toxicon.2018.10.304
Fusto G, Bennardo L, Duca ED, et al. Spider bites of medical significance in the Mediterranean area: misdiagnosis, clinical features and management. J Venom Anim Toxins Incl Trop Dis 2020;26:e20190100.
DOI: https://doi.org/10.1590/1678-9199-jvatitd-2019-0100
Charlebois J, Rivard GÉ, St-Louis J. Management of acquired hemophilia A: Review of current evidence. Transfus Apher Sci 2018;57:717-20.
DOI: https://doi.org/10.1016/j.transci.2018.10.011
Franchini M, Vaglio S, Marano G, et al. Acquired hemophilia A: a review of recent data and new therapeutic options. Hematology 2017;22:514-20.
DOI: https://doi.org/10.1080/10245332.2017.1319115
Collins P, Baudo F, Huth-Kühne A, et al. Consensus recommendations for the diagnosis and treatment of acquired hemophilia A. BMC Res Notes 2010;3:161.
DOI: https://doi.org/10.1186/1756-0500-3-161
Huth-Kühne A, Baudo F, Collins P, et al. International recommendations on the diagnosis and treatment of patients with acquired hemophilia A. Haematologica 2009;94:566-75.
DOI: https://doi.org/10.3324/haematol.2008.001743
Kessler CM, Knöbl P. Acquired haemophilia: an overview for clinical practice. Eur J Haematol 2015;95:36-44.
DOI: https://doi.org/10.1111/ejh.12689
Baudo F, Collins P, Huth-ku A. Management of bleeding in acquired hemophilia A: results from the European Acquired Haemophilia (EACH2) Registry. Blood 2012;120:39-46.
DOI: https://doi.org/10.1182/blood-2012-02-408930
Di Nisio M, Baudo F, Cosmi B, et al. Diagnosis and treatment of disseminated intravascular coagulation: Guidelines of the Italian Society for Haemostasis and Thrombosis (SISET). Thromb Res 2012;129:e177-84.
DOI: https://doi.org/10.1016/j.thromres.2011.08.028
Rader RK, Stoecker WV, Malters JM, et al. Seasonality of brown recluse populations is reflected by numbers of brown recluse envenomations. Toxicon 2012;60:1-3.
DOI: https://doi.org/10.1016/j.toxicon.2012.03.012
Helena L, Trevisan-silva D, Pereira V, et al. Recent advances in the understanding of brown spider venoms: From the biology of spiders to the molecular mechanisms of toxins. Toxicon 2014;83:91-120.
DOI: https://doi.org/10.1016/j.toxicon.2014.02.023
Planas E, Zobel-thropp PA, Ribera C, Binford G. Not as docile as it looks? Loxosceles venom variation and loxoscelism in the Mediterranean Basin and the Canary Islands. Toxicon 2015;93:11-19.
DOI: https://doi.org/10.1016/j.toxicon.2014.10.005
Stuber M, Nentwig W. How informative are case studies of spider bites in the medical literature ? Toxicon 2016;114:40-4.
DOI: https://doi.org/10.1016/j.toxicon.2016.02.023
Pauli I, Puka J, Gubert IC, Minozzo JC. The efficacy of antivenom in loxoscelism treatment. Toxicon 2006;48:123-37.
DOI: https://doi.org/10.1016/j.toxicon.2006.05.005
Collins PW, Chalmers E, Hart D, et al. Diagnosis and management of acquired coagulation inhibitors: a guideline from UKHCDO. Br J Haematol 2013;162:758-73.
DOI: https://doi.org/10.1111/bjh.12463
Collins PW, Hirsch S, Baglin TP, et al. Acquired hemophilia A in the United Kingdom: a 2-year national surveillance study by the United Kingdom Haemophilia Centre Doctors’ Organisation. Blood 2007;109:1870-7.
DOI: https://doi.org/10.1182/blood-2006-06-029850
How to Cite
Zattera, C., Luly, S., Cipriano, A., Rizzelli, G. M. L., Cecconi, N., & Santini, M. (2022). An unexpected turn of events: A rare case of Acquired Haemophilia A after a violin spider bite. Emergency Care Journal, 18(2). https://doi.org/10.4081/ecj.2022.10457
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