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A 6-month-old boy with severe haemophilia-A exhibited lack of efficacy during treatment with rurioctocog-alfa-pegol, leading to increased spontaneous ecchymosis despite receiving the medication. After switching to efanesoctocog-alfa, he experienced zero breakthrough bleeding episodes. The boy had previously received octocog-alfa and red blood cell transfusion for decreased hemoglobin, with genetic testing revealing an F8 gene variant. This case report highlights the importance of monitoring and adjusting treatment for patients with severe haemophilia-A to ensure optimal outcomes. [Extracted from the article]

Two cases of intramuscular haematoma and intracranial haemorrhage were reported in an 85-year-old woman and an 89-year-old man receiving heparin for venous thromboembolism prophylaxis at NYU Langone hospital in the USA. The woman had multiple comorbidities and underwent craniotomy for the intracranial haemorrhage, while the man developed intramuscular haematoma and acute blood loss anaemia. Both patients were discharged in stable condition after appropriate treatment. [Extracted from the article]

A 10-year-old boy developed drug-induced liver injury (DILI) while being treated for granulomatosis with polyangiitis (GPA) with avacopan, methylprednisolone, and rituximab. He experienced symptoms such as abdominal pain, diarrhea, gingivitis, and purpura before being diagnosed with GPA. After discontinuing avacopan and rituximab, his liver function improved, indicating a possible link between the medications and the liver injury. [Extracted from the article]

An 88-year-old man developed acquired haemophilia A (AHA) while being treated with pembrolizumab for bladder cancer. He had a complex medical history including coronary artery disease, hypertrophic obstructive cardiomyopathy, and hashimoto's thyroiditis. The man was successfully treated with eptacog-alfa, susoctocog-alfa, prednisone, and cyclophosphamide, leading to remission of AHA for 8 months after pembrolizumab was discontinued. [Extracted from the article]

A 64-year-old man experienced diffuse alveolar haemorrhage while being treated with prasugrel and aspirin for acute coronary syndrome. He presented with haemoptysis and shortness of breath, leading to a diagnosis of severe anaemia and prolonged INR. Further investigation revealed underlying celiac disease as a contributing factor, which was managed with a gluten-free diet and vitamin supplementation. With appropriate treatment, the man's condition improved, and he did not experience further bleeding episodes. [Extracted from the article]

An 82-year-old woman experienced intracranial hemorrhage while being treated with apixaban for anticoagulant therapy. Despite initial improvement with apixaban, her condition worsened, leading to a decline in mental status and ultimately death. The decision was made to reverse the effects of apixaban with andexanet-alfa, but unfortunately, this treatment was ineffective, resulting in the patient's passing. [Extracted from the article]

A 77-year-old woman experienced a spontaneous small bowel hematoma after taking an overdose of acenocoumarol for arrhythmia and atrial fibrillation. She presented with abdominal pain and tenderness in the right iliac fossa. Laboratory tests showed abnormal levels of prothrombin, international normalized ratio (INR), activated partial thromboplastin time (aPTT), and C-reactive protein. A CT scan revealed thickening of the small bowel wall and a parietal hematoma. The woman was treated with vitamin K1 and plasma transfusion, and her condition improved. After 15 days, she was discharged and transferred to the cardiology unit for follow-up. [Extracted from the article]

A 67-year-old woman developed acute myeloid leukemia while undergoing treatment for breast cancer with epirubicin, cyclophosphamide, trastuzumab, and pertuzumab. She presented with a low fever and laboratory tests showed abnormal blood counts and clotting factors. Bone marrow examination confirmed the diagnosis of acute myeloid leukemia. Despite achieving complete remission with treatment, the woman experienced a relapse in the bone marrow and central nervous system and ultimately passed away. Genetic testing revealed a fusion gene associated with the leukemia. [Extracted from the article]

A 46-year-old man experienced a lack of efficacy while being treated with heparin for femoral vein thrombosis. He presented with symptoms such as nausea, anorexia, fever, pain in both thighs, and gastrointestinal symptoms. The man had a history of cholecystectomy and was diagnosed with hypereosinophilic syndrome (HES) with acute liver injury. Thrombus formation was also observed in several central veins. Despite treatment with heparin, the patient developed sudden chest pain and dyspnea, leading to cardiopulmonary arrest and a subsequent diagnosis of acute pulmonary embolism (PE) associated with deep vein thrombosis (DVT). Despite attempts at resuscitation and thrombolytic therapy, the patient passed away. [Extracted from the article]

A 25-year-old man developed haemorrhagic Varicella and reactivation of Cytomegalovirus (CMV) infection while being treated with prednisone for nephrotic syndrome. He was hospitalized with symptoms including haemorrhagic vesicles, abdominal pain, and elevated levels of various markers in his blood. Despite treatment with multiple medications, his condition worsened and he ultimately died due to complications including disseminated intravascular coagulation (DIC), septicaemia, haemorrhagic shock, and acute liver failure. It was determined that the haemorrhagic Varicella and CMV reactivation were caused by the prednisone therapy, and these factors, along with other complications, contributed to his death. [Extracted from the article]

An 18-year-old man developed toxic leukoencephalopathy while being treated with methotrexate for acute lymphoblastic leukemia (ALL). After receiving methotrexate therapy, he experienced weakness in his right arm, slurred speech, motor aphasia, and dysphagia. Laboratory tests showed abnormal results, and brain imaging confirmed the diagnosis of methotrexate-induced toxic leukoencephalopathy. The man received physical therapy and gradually improved, with a follow-up MRI showing resolution of the brain lesion. [Extracted from the article]

An 85-year-old man developed acquired haemophilia A after receiving the tozinameran COVID-19 vaccine. He had a complex medical history and experienced symptoms such as swelling, pain, and bleeding in his extremities after the second dose of the vaccine. Treatment included prednisone, red blood cell transfusions, and rFVIIa administration, with some improvement noted before complications arose following a third dose of the vaccine. The patient's condition was managed with medication and ongoing monitoring. [Extracted from the article]

A 56-year-old man developed severe acquired hemophilia A (AHA) after receiving the tozinameran COVID-19 vaccine, leading to significant bleeding and intracranial hemorrhage. Despite treatment with eptacog-alfa and later with methylprednisolone, cyclophosphamide, and dexamethasone, the patient's FVIII inhibitor titer fluctuated, ultimately resulting in his passing due to sepsis after 14 weeks of hospitalization. The case highlights the challenges in managing AHA and the complexities of treating patients with severe bleeding disorders. [Extracted from the article]

A 67-year-old man experienced a lack of efficacy during anticoagulant reversal therapy with protamine sulfate. The man had a history of atrial fibrillation, antineutrophil cytoplasmic antibody-associated vasculitis, and type II diabetes. He underwent emergency surgery for a type A aortic dissection and received protamine sulfate for anticoagulant reversal, but clots did not form and controlling bleeding was difficult. Andexanet alfa was then administered, which effectively controlled the surgical bleeding. The man had an uneventful postoperative course and was discharged after 19 days. [Extracted from the article]

A 65-year-old woman developed a blood coagulation disorder while being treated with cefmenoxime for acute pancreatitis. The woman had a history of chronic renal failure, type-2 diabetes, and hypertension. She started experiencing multiple ecchymoses and bleeding, which prompted laboratory tests revealing abnormalities in her coagulation function. The blood coagulation disorder was attributed to cefmenoxime, and the medication was discontinued. The woman was then treated with amoxicillin and clavulanic-acid, along with phytomenadione. Her symptoms improved, and she was transferred to a higher-level hospital for further treatment. [Extracted from the article]

A 26-year-old woman experienced extensive pulmonary embolism (PE) after receiving the tozinameran vaccine for COVID-19. She presented with symptoms such as shortness of breath, palpitations, and chest pain, and was found to have PE based on laboratory tests and a chest CT-angiography. The woman was admitted to the ICU and received treatment with enoxaparin-sodium and alteplase, followed by apixaban. Her condition improved, and she was eventually discharged. Follow-up tests showed no abnormalities, and her medication was discontinued. [Extracted from the article]

A 61-year-old man with stage VB lung adenocarcinoma developed acquired coagulation factor V deficiency and liver dysfunction during treatment with osimertinib and gefitinib. He also experienced lack of efficacy during treatment with gefitinib, carboplatin, and paclitaxel. The patient's factor V activity significantly decreased, and antibodies against Factor V were detected, indicating autoimmune acquired coagulation factor V deficiency secondary to osimertinib. Treatment with prednisolone improved his coagulation times, but his condition worsened with the development of new liver and brain lesions. Despite rechallenge with osimertinib and the initiation of apixaban, the patient ultimately passed away due to liver dysfunction. [Extracted from the article]

A case report published in Reactions Weekly describes the experience of a young girl who developed lupus anticoagulant hypoprothrombinaemia syndrome (LAHPS) and systemic lupus erythematosus (SLE). The girl initially responded well to treatment with prednisone and hydroxychloroquine, but experienced a rebound effect and lack of efficacy when her prednisone dose was reduced and rituximab was introduced. She required higher doses of prednisone and additional treatments, including mycophenolate-mofetil and cyclophosphamide. Eventually, she developed lupus nephritis and was given methylprednisolone. At the time of the report, her prothrombin levels had normalized and she remained on a treatment regimen. [Extracted from the article]

A 47-year-old woman with asthma experienced a lack of efficacy during treatment with various medications, including epinephrine, magnesium sulfate, ketamine, β-adrenergic-receptor-agonists, and corticosteroids. Despite receiving these treatments, her condition did not improve, and she required intubation. Additional interventions, such as femoral-jugular venovenous extracorporeal membrane oxygenation (VV-ECMO) and radiotherapy, were attempted, but the woman ultimately succumbed to widespread cancer metastasis. The article provides a detailed account of the patient's medical history and treatment, highlighting the challenges faced in managing her condition. [Extracted from the article]

A 49-year-old woman was hospitalized after intentionally overdosing on the medication apixaban. She had a history of schizophrenia, allergic rhinitis, and iron-deficiency anemia, and was taking various antipsychotics and allergy medications. The woman ingested 70 tablets of apixaban, which was prescribed for her boyfriend. She experienced coagulopathy as a result of the overdose, but was treated with activated charcoal and vitamin K and eventually discharged without complications. [Extracted from the article]

A 67-year-old man experienced an unusual increase in his international normalized ratio (INR) while being treated with apixaban. The man had a medical history of heart failure, atrial flutter, and chronic kidney disease. He presented with symptoms such as shortness of breath, blood-tinged sputum, and generalized swelling. Lab results showed elevated INR levels, which were attributed to the use of apixaban. The patient was withdrawn from apixaban and received treatment with vitamin K, which eventually improved his INR levels. He remained stable during hospitalization and was discharged. [Extracted from the article]

A 66-year-old woman developed diffuse large B-cell lymphoma (DLBCL) type lymphoproliferative disorder (LPD) while being treated with methotrexate for rheumatoid arthritis. She had been taking methotrexate along with sulfasalazine and iguratimod for 2 years. She was admitted to the hospital with tarry stools and was found to have anemia. Further tests revealed the presence of Epstein-Barr virus (EBV) DNA in her blood and the presence of tumors in her liver and colon. After discontinuing methotrexate, the tumors spontaneously shrank and there was no sign of recurrence. [Extracted from the article]

Two case reports describe patients who developed immune thrombotic thrombocytopenia after receiving the Ad26.COV2-S COVID-19 vaccine. One patient experienced lack of efficacy with prednisolone, apixaban, and immune-globulin treatment, while the other patient responded well to treatment with IV immune-globulin, apixaban, and methylprednisolone. Both patients eventually showed improvement and had negative ELISA HIT assay results. The Ad26.COV2-S-induced thrombotic thrombocytopenia resembles heparin-induced thrombocytopenia. [Extracted from the article]

A 34-year-old woman experienced multiple toxicities while being treated for various conditions. She developed acquired haemophilia A, characterized by ecchymosis and bleeding, during treatment with diclofenac for pain. She also experienced chest pain, dyspnea, and nausea while being treated with factor-VIII-inhibitor-bypassing-fraction for acquired haemophilia A. Additionally, her condition worsened during treatment with enoxaparin-sodium for deep venous thrombosis. The woman was eventually diagnosed with acquired haemophilia A and received treatment with factor-VIII-inhibitor-bypassing-fraction, prednisone, and cyclophosphamide. She eventually improved and was discharged from the hospital. [Extracted from the article]

A 66-year-old woman experienced a condition known as BRASH syndrome, which includes symptoms such as bradycardia, renal failure, atrioventricular node blocking, shock, and hyperkalemia. This occurred while she was being treated for hypertension and atrial fibrillation with medications such as bisoprolol, furosemide, ramipril, spironolactone, and digoxin. The woman also suffered from digoxin toxicity due to an overdose and lack of efficacy with calcium-chloride treatment for severe hyperkalemia. She received various treatments, including dialysis and digoxin-immune-fab, and eventually recovered but experienced complications such as pneumonia and epistaxis. At the end of her hospitalization, she was diagnosed with chronic kidney disease and remained in chronic atrial fibrillation. The BRASH syndrome was attributed to the combination of medications she was taking. [Extracted from the article]

A 45-year-old woman with acquired hemophilia (AH) experienced a lack of efficacy with factor VIII treatment. She presented to the emergency department with symptoms of spontaneous hemoptysis and odynophagia, and was diagnosed with AH. Despite receiving factor VIII, she did not respond to the treatment. She subsequently developed brain edema, respiratory distress, and other complications, including sepsis and COVID-19. Despite attempts at resuscitation, she ultimately died due to the progression of AH. The failure of factor VIII treatment was considered a contributing factor to her death. [Extracted from the article]

A 59-year-old woman developed immune haemolytic anaemia while being treated with ceftizoxime to prevent infection. She had previously undergone polypectomy and was later diagnosed with adenocarcinoma. After receiving ceftizoxime, she experienced symptoms of an anastomotic fistula and developed a rash, itching, and difficulty breathing. Her lab tests showed abnormalities in her blood counts and clotting function, and she experienced renal failure. Treatment included transfusion of red blood cells and plasma. The woman's symptoms improved after ceftizoxime was discontinued. [Extracted from the article]

A 61-year-old man developed thrombotic microangiopathy due to scleroderma renal crisis while being treated with prednisone and rituximab for systemic sclerosis-associated interstitial lung disease. The man had a medical history of systemic sclerosis-associated interstitial lung disease and was also on chronic prednisone and tocilizumab. After receiving rituximab as a rescue therapy, he developed acute kidney injury. A kidney biopsy confirmed the diagnosis of thrombotic microangiopathy due to scleroderma renal crisis, with rituximab considered as a precipitating factor and previous corticosteroid use with prednisone as a risk factor. [Extracted from the article]

A retrospective evaluation of 53 critically ill adult patients with low body weight who received heparin for evaluating activated partial thromboplastin time (aPTT) prolongation found one patient who exhibited lack of efficacy during treatment for venous thromboembolism (VTE) prophylaxis. The patient, whose age and sex were not stated, received subcutaneous heparin for thromboprophylaxis but still developed VTE. [Extracted from the article]

A 79-year-old man experienced reduced fibrinogen levels, prolonged prothrombin time (PT), and prolonged activated partial thromboplastin time (APTT) due to an overdose of dabigatran etexilate, a medication used for anticoagulation. The man had been receiving treatment for chronic renal insufficiency and was admitted to the hospital with anuria. After receiving charcoal treatment, his coagulation parameters returned to normal. This case highlights the potential complications of dabigatran etexilate overdose and the importance of monitoring coagulation parameters in patients taking this medication. [Extracted from the article]

A patient developed factor X deficiency while being treated with apixaban and enoxaparin-sodium for atrial fibrillation. The patient had a history of atrial fibrillation and anaemia, and their prothrombin time and activated partial thromboplastin time were mildly prolonged before starting apixaban. The patient was admitted to the ICU with worsening anaemia, renal function, hepatic function, and coagulation function. Despite discontinuing the medications, the patient died due to complications of factor X deficiency, including cardiocirculatory arrest and worsening anaemia, renal function, hepatic function, and coagulation function. [Extracted from the article]

A 61-year-old man developed thrombotic microangiopathy due to scleroderma renal crisis while being treated with prednisone and rituximab for systemic sclerosis-associated interstitial lung disease. The man had a medical history of systemic sclerosis-associated interstitial lung disease and was also on chronic prednisone and tocilizumab. After receiving rituximab as a rescue therapy, he developed acute kidney injury. A kidney biopsy confirmed the diagnosis of thrombotic microangiopathy due to scleroderma renal crisis, with rituximab considered as a precipitating factor and previous corticosteroid use with prednisone as a risk factor. [Extracted from the article]

A retrospective evaluation of 53 critically ill adult patients with low body weight who received heparin for evaluating activated partial thromboplastin time (aPTT) prolongation found one patient who exhibited lack of efficacy during treatment for venous thromboembolism (VTE) prophylaxis. The patient, whose age and sex were not stated, received subcutaneous heparin for thromboprophylaxis but still developed VTE. [Extracted from the article]

A 79-year-old man experienced reduced fibrinogen levels, prolonged prothrombin time (PT), and prolonged activated partial thromboplastin time (APTT) due to an overdose of dabigatran etexilate, a medication used for anticoagulation. The man had been receiving treatment for chronic renal insufficiency and was admitted to the hospital with anuria. After receiving charcoal treatment, his coagulation parameters returned to normal. This case highlights the potential complications of dabigatran etexilate overdose and the importance of monitoring coagulation parameters in patients taking this medication. [Extracted from the article]

A patient developed factor X deficiency while being treated with apixaban and enoxaparin-sodium for atrial fibrillation. The patient had a history of atrial fibrillation and anemia, and their prothrombin time and activated partial thromboplastin time were mildly prolonged before starting apixaban. The patient was admitted to the ICU with worsening anemia, renal function, hepatic function, and coagulation function. Despite discontinuing the medications, the patient died due to complications of factor X deficiency, including cardiocirculatory arrest and worsening anemia, renal function, hepatic function, and coagulation function. [Extracted from the article]

A 68-year-old man developed acquired hemophilia A with anti factor-VIII while being treated with ticagrelor for hyperlipidemia. He also experienced lack of efficacy during treatment with factor-VIII-inhibitor-bypassing-fraction and recombinant-factor-VIIa for acquired hemophilia A with anti factor VIII. The man had a history of hyperlipidemia and hypertension and had received drug eluting stents after a cardiac arrest due to non-ST-elevation myocardial infarction. He started receiving treatment with atorvastatin, aspirin, ticagrelor, and metoprolol succinate. Despite receiving steroids and later being switched to clopidogrel monotherapy, he developed a retroperitoneal bleed and ultimately died from hemorrhagic shock. [Extracted from the article]

A 16-year-old girl experienced a lack of efficacy while being treated with heparin for pulmonary embolism. Despite maintaining the appropriate levels of heparin, her symptoms persisted, indicating that the treatment was not effective. As a result, the medical team decided to pursue catheter-directed therapies, including percutaneous embolectomy and low-dose-local-thrombolysis. This approach led to an improvement in her symptoms, and she was eventually discharged from the hospital without any restrictions on physical activity. [Extracted from the article]

This article describes three cases of individuals who experienced various toxicities and complications related to the use of warfarin, a blood-thinning medication. In the first case, a 32-year-old man developed bleeding in the oral cavity and haematuria as a result of warfarin intoxication. The second case involves a 26-year-old woman who experienced haemorrhagic complications in the gastrointestinal and gynecological tract, leading to pulmonary thromboembolism. The third case involves a 35-year-old woman who experienced hypermenorrhagia and intense nosebleeds due to warfarin intoxication. These cases highlight the potential risks and complications associated with the use of warfarin. [Extracted from the article]

A 74-year-old woman experienced an infusion reaction and lack of efficacy during treatment with rituximab and factor-VIII/von-Willebrand-factor for acquired von Willebrand syndrome. She had an elevated activated partial thromboplastin time and laboratory testing revealed low factor VIII activity, von Willebrand antigen, and von Willebrand factor ristocetin cofactor activity. Her condition was more severe than typical types of von Willebrand disease, suggesting a potential subtype or variant. She was eventually diagnosed with MGUS-associated acquired von Willebrand syndrome and treated with bortezomib and dexamethasone, resulting in the resolution of her symptoms. [Extracted from the article]

A 72-year-old woman developed cerebral hemorrhage while being treated with nivolumab and cabozantinib for advanced renal cell carcinoma. She experienced forgetfulness and urinary incontinence and had a medical history of ureteral stones and hypertension. After undergoing various analyses, she was diagnosed with advanced renal cell carcinoma and started on combination therapy. She later developed consciousness disturbances and generalized convulsions, and a CT scan revealed bleeding from brain metastasis. The woman received conservative treatment for the cerebral hemorrhage and showed improvement on subsequent imaging. She was able to restart treatment and showed no progression six months later. [Extracted from the article]

A case report published in Reactions Weekly describes a man in his 80s who experienced masking of acquired haemophilia A while being treated with apixaban for deep vein thrombosis. The man initially presented with left hip pain after a fall and was found to have a haematoma in the left gluteus medius. His prothrombin time and activated partial thromboplastin time were prolonged, which was initially attributed to apixaban. However, further investigation revealed that he had acquired haemophilia A, which had been masked by the use of apixaban. The report highlights the importance of considering acquired haemophilia A as a potential cause of prolonged clotting times in patients receiving apixaban. [Extracted from the article]