{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:59:29Z","timestamp":1760151569703,"version":"build-2065373602"},"reference-count":12,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T00:00:00Z","timestamp":1648598400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hematology Reports"],"abstract":"<jats:p>Reports on the treatment of bleeding associated with emicizumab administration are scarce. Herein, we report the case of an eight-year-old boy with moderate hemophilia A with an inhibitor who experienced tonsillar hemorrhage while undergoing emicizumab treatment. He visited our hospital for postprandial bloody vomiting. The activated partial thromboplastin time was 20.8 s; only a small amount of hemorrhage was observed in the retropharyngeal space, and tranexamic acid was administered. He experienced hematemesis on Day 2 of hospitalization, and fiberoptic laryngoscopy confirmed hemorrhage from the posterior tonsil. Varicose vessels were observed at the soft palate, and considering thrombosis, an emergency cauterization was performed instead of bypass therapy. In small children, observing the tonsils is difficult, and the coagulation ability of the patient with hemophilia A is inferior to that of healthy people, even under emicizumab administration. Thus, active hemorrhage assessment and appropriate hemostatic control are necessary.<\/jats:p>","DOI":"10.3390\/hematolrep14020016","type":"journal-article","created":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T21:24:42Z","timestamp":1648675482000},"page":"108-111","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Traumatic Tonsillar Hemorrhage during Hemophilia A Treatment with Emicizumab"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2091-4910","authenticated-orcid":false,"given":"Fumiya","family":"Inoue","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Narita Red Cross Hospital, Narita City 286-8523, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6797-9546","authenticated-orcid":false,"given":"Kazuki","family":"Terada","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Narita Red Cross Hospital, Narita City 286-8523, Japan"},{"name":"Department of Pediatric Hematology and Oncology, Narita Red Cross Hospital, Narita City 286-8523, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuki","family":"Furudate","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Narita Red Cross Hospital, Narita City 286-8523, Japan"},{"name":"Department of Pediatric Hematology and Oncology, Narita Red Cross Hospital, Narita City 286-8523, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8349-5851","authenticated-orcid":false,"given":"Yasushi","family":"Noguchi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Narita Red Cross Hospital, Narita City 286-8523, Japan"},{"name":"Department of Pediatric Hematology and Oncology, Narita Red Cross Hospital, Narita City 286-8523, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunji","family":"Igarashi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Narita Red Cross Hospital, Narita City 286-8523, Japan"},{"name":"Department of Pediatric Hematology and Oncology, Narita Red Cross Hospital, Narita City 286-8523, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e2707","DOI":"10.1136\/bmj.e2707","article-title":"Diagnosis and management of haemophilia","volume":"344","author":"Fijnvandraat","year":"2012","journal-title":"BMJ"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1056\/NEJMoa1803550","article-title":"Emicizumab prophylaxis in patients who have hemophilia a without inhibitors","volume":"379","author":"Mahlangu","year":"2018","journal-title":"N. 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Med."},{"key":"ref_7","first-page":"325","article-title":"New challenge for treatment of hemophilia A by using bispecific antibody","volume":"89","author":"Kitazawa","year":"2017","journal-title":"Seikagaku"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1017\/S0022215109992696","article-title":"Management of spontaneous tonsillar bleeding: Review","volume":"124","author":"Salem","year":"2010","journal-title":"J. Laryngol. Otol."},{"key":"ref_9","first-page":"115","article-title":"Surgical experience from four phase III studies (HAVEN 1\u20134) of emicizumab in persons with haemophilia A (PwHA) with or without FVIII inhibitors. [OC 60.1], Nurses and Orals Abstracts","volume":"3","author":"Santagostino","year":"2019","journal-title":"Res. Pract. Thromb. Haemost."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2127","DOI":"10.1182\/blood.2019001869","article-title":"A multicenter, open-label phase 3 study of emicizumab prophylaxis in children with hemophilia A with inhibitors","volume":"134","author":"Young","year":"2019","journal-title":"Blood"},{"key":"ref_11","first-page":"299","article-title":"Prophylaxis with emicizumab in children and adults with hemophilia A and inhibitors: Preliminary data on 7 patients of a portuguese hemophilia center","volume":"3","author":"Catarino","year":"2019","journal-title":"Res. Pract Thromb Haemost"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e27886","DOI":"10.1002\/pbc.27886","article-title":"Emicizumab prophylaxis among infants and toddlers with severe hemophilia A and inhibitors\u2014A single-center cohort","volume":"66","author":"Barg","year":"2019","journal-title":"Pediatr. Blood Cancer"}],"container-title":["Hematology Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2038-8330\/14\/2\/16\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:46:25Z","timestamp":1760136385000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2038-8330\/14\/2\/16"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,30]]},"references-count":12,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["hematolrep14020016"],"URL":"https:\/\/doi.org\/10.3390\/hematolrep14020016","relation":{},"ISSN":["2038-8330"],"issn-type":[{"type":"electronic","value":"2038-8330"}],"subject":[],"published":{"date-parts":[[2022,3,30]]}}}