Feedback00:52 Intro and chuckles01:40 Case study: 75M, left calf swelling, put on DOAC, 24 hrs later haematoma and deep bleed on CT06:00 General informationElderly (>65), Mortality 8-40%Common presentations: GI and UG bleeding, Retroperitoneal and muscle bleeds (compartment syndrome)Ptegnancy, TTP, Malignancy (15%), Autoimmune disease (17%)08:56 Pathogenesis and diagnosis: AutoAb against F8*Bethesda units do not correlate with bleeding phenotype in Acquired HA- second orfer kinetics*HistoryAPTT, PT (isolated raised APTT)Mixing studies: 50/50 or 80/20 mixFactor Assays (**Intrinsic**)Decreased Factor VIII + Non-paralellism -> Bethesday Assay20:20 Non-clotting investigations22:05 TreatmentMDT + Comprehensive Care Center escalationRICE., TXA, Bypassing agentsLimit iatrogenic bleedingReview medicationsPregnancy: birth plan!!! inhibitor can cross palcentaSteroid +/- Cyclophosphamide27:10 Bypassing Agents in Acquired Haemophilia AFENOC + EACH2 study: FEIBA vs NovoSeven = No difference in bleeding/thrombosis rates- more info at 33:25 for EACH2Obizor can be titrated according to response whereas FEIBA and NovoSeven cannotEmicizimab +/- Immunosuppression = Not currently licesnsed in the UK 32:25 Inhibitor eradicationMean time to remission: 5 weeksGood prognostic markers: FVIII 1 or more, Inhibitor titre < 20EACH 2 Study: Steroids -> Steroids + Cyclophosphamide -> Steroids + Cyclo + RituximabBiggest cause of death: infection36:45 Follow up Weekly FVIII levels and inhibitor monitoring till remission then monthly for 6 months then 2-3 monthly for a yearPlanned procedure; FVIII level38:45 Golden Nuggets 'Basics to Brilliance: Haematology Podcast' has been accredited for CPD credit by the Royal College of Pathologists UK. Medical professionals and clinical scientists holding career-grade positions, who are registered with any of the Royal Colleges for CPD, will be eligible to earn 1 credit for every hour of learning. Email: [email protected] Insta: BasicstoBrilliance X: @basics_2_brill Send us your feedback!

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