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Circulating Anticoagulant in a Macroglobulin with Factor VIII Inhibitory Activity.

Eugene M. McKelvey, M.D.; and Hau C. Kwaan, M.D., F.R.C.P.(Edin.)
Ann Intern Med. 1968;68(5):1170. doi:10.7326/0003-4819-68-5-1170_3
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Circulating anticoagulants in the form of acquired factor VIII inhibitors have typically been identified as immunoglobulin (Ig)G proteins. However, in a patient presented with a 2-year history of arthralgia and Raynaud's phenomenon, a factor VIII inhibitor was found associated with the serum macroglobulins. The patient was initially hospitalized for a herniorrhaphy, and detailed preoperative coagulation studies were completely normal. Postoperatively, the patient developed a pulmonary embolism, and anticoagulation therapy was initiated. The patient exhibited a marked sensitivity to warfarin. After this drug had been withdrawn, coagulation studies continued to demonstrate a clotting defect, and a specific factor VIII inhibitor was


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Circulating anticoagulants: physiologic and pathophysiologic. Hosp Pract (Off Ed) 1983;18(2):169-72, 179-83, 186.
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