How does Emicizumab impact factor replacement?
Patient's Query
Hello doctor,
A patient with severe hemophilia A and suspected intracranial bleeding after a minor car accident. Factor levels are less than 1 %. The patient is on Emicizumab prophylaxis, with the last dose administered five days ago. A CT head scan is pending. The ER is inquiring about the immediate need for factor replacement, while hematology is calculating the rescue dose. How urgent is the factor replacement before imaging?
Kindly help.
Thank you.
Hello,
Welcome to icliniq.com.
I can understand your concern.
Factors should be replaced as soon as available to prevent further bleeding and cranial damage. It is better to start with FFP (fresh frozen plasma) followed by infused factors. After that, CT (computed tomography) imaging can be done, as the priority is to prevent bleeding and manage the emergency. Imaging can be performed later since the factor level is very low. A minimum of 30 percent factor level is required, and ideally, 50 percent if possible. I hope this clarifies the situation. Take care, and God bless you. Please send me the imaging report and factor levels once completed. I hope this information helps you.
Please let us know if you have any further queries.
Thank you.
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