[Autoantibodies and anti-factor VIII and Chlamydia pneumoniae infection]

We report the case of a 64-year-old man without hemorrhagic history experiencing epistaxis. The standard hemostasis assessment including prothrombin index, activated partial thromboplastin time (APTT) and platelet count found an isolated abnormal APTT (105 sec vs 33 sec). Therefore, coagulation factors were explored. An acquired factor VIII deficiency (5%) with anti-FVIII antibody (4.5 Bethesda unit.mL-1) was recognised. This anti-FVIII antibody was related to a Chlamydia pneumoniae pulmonary infection. Treatment consisted of: i) Four successive anterior packing and activated factor VII infusion (Novoseven); ii) steroids injection and bi-antibiotherapy. The time course of the epistaxis was favourable under treatment.

[Importance of symptomatic balance in peripheral arterial surgery]

A clinical and radiological study searching for a dental or oral infection was performed on thirty six patients before arterial reconstruction by prosthesis. Potential oral or dental infection was found in 16 cases and dental extraction was performed. Previous studies confirmed the interest of oral or dental examination before any vascular prosthesis, which could be a reasonable attitude.