Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2021; 9(31): 9592-9597
Published online Nov 6, 2021. doi: 10.12998/wjcc.v9.i31.9592
Forearm compartment syndrome due to acquired hemophilia that required massive blood transfusions after fasciotomy: A case report
Takuya Kameda, Takeru Yokota, Soichi Ejiri, Shin-ichi Konno
Takuya Kameda, Takeru Yokota, Shin-ichi Konno, Department of Orthopaedic Surgery, Fukushima Medical University, Fukushima 960-1295, Fukushima, Japan
Soichi Ejiri, Department of Hand and Limb Reconstructive Surgery, Fukushima Medical University, Fukushima 960-1295, Fukushima, Japan
Author contributions: Kameda T collected clinical data and wrote the paper; Kameda T, Yokota T and Ejiri S managed the patient; Ejiri S and Konno S critically reviewed the manuscript; all authors approved the final version.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors do not have any conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Takuya Kameda, MD, PhD, Assistant Professor, Department of Orthopaedic Surgery, Fukushima Medical University, 1 Hikarigaoka, Fukushima 960-1295, Fukushima, Japan. a0001826@fmu.ac.jp
Received: April 24, 2021
Peer-review started: April 24, 2021
First decision: May 24, 2021
Revised: June 20, 2021
Accepted: October 11, 2021
Article in press: October 11, 2021
Published online: November 6, 2021
Core Tip

Core Tip: Whether we should perform fasciotomy for compartment syndrome caused by acquired hemophilia is unclear. A 75-year-old woman admitted with severe pain of the right forearm was diagnosed as having compartment syndrome, and fasciotomy was performed. Laboratory data showed acquired hemophilia A. Though recombinant activated clotting factor VII (rFVIIa) was administered, transfused red blood cells reached 46 units, and the cost of the clotting factor was 28834600 yen. Final hand function was good, but life-threatening bleeding and the high cost of treatment were serious problems. Preparation for sufficient blood transfusion, preoperative administration of rFVIIa, and prompt fasciotomy could be ideal.