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Acquired Inhibitors

If you weren’t born with hemophilia and yet acquire an inhibitor later in life, you may be far more baffled than those with the condition from birth. To help, here’s a quick overview of acquired inhibitors.

Acquired inhibitors are also known as acquired hemophilia. It’s a condition where your immune system starts to see one of its clotting factors as foreign and makes antibodies to help the body destroy the clotting factor. These antibodies are the inhibitors, and they stop the clotting factor from doing its job.

Who’s at risk?

Statistically, people who meet the following criteria are more likely to acquire inhibitors:

• Over 50 years of age (under 20 years of age for non-acquired inhibitors)
• Autoimmune disorders such as systemic lupus erythematosus or rheumatoid arthritis
• Recent pregnancy
• Malignancies such as lymphoma, acute or chronic lymphocytic leukemias, and solid tumors
• Dermatologic diseases
• Exposure to penicillins, phenytoin, phenylbutazones, or chloramphenicol

The signs

Bleeding episodes for people with acquired inhibitors are somewhat different than for people with hemophilia who have inhibitors. People with acquired inhibitors will experience significant swelling and/or bruising of one part of the body. Other signs can include tea-colored urine (can be a sign of bleeding in the bladder or kidney); black stools (bleeding into the bowel); and problems with eyesight, blurring vision, headache, or dizziness (internal bleeding).

The treatment

Treatment for acquired inhibitors is similar to that for people with hemophilia who have inhibitors. People with acquired hemophilia sometimes are treated with special hospital procedures in the event of life- or limb-threatening bleeding episodes, according to Lacroix. One procedure is plasmapheresis, in which the person's plasma, which contains the inhibitor, is removed and replaced with albumin and/or plasma. Once the inhibitor level is lowered, factor concentrates are given. The other procedure is immunoadsorption, in which the plasma is passed through a machine that removes only the antibodies. The person’s plasma is then returned to the body without the inhibitor. The procedure is lengthy — about six hours — and has to be repeated for several days until the bleeding is controlled and a factor level is maintained. In Lacroix's center, simultaneous immunosuppressant therapy is used to help stop the production of the inhibitor.

Note: thereforyou.com does not recommend a particular treatment for specific individuals and recommends that you consult your treatment center or physician before pursuing any course of treatment.