Emicizumab Associated Rhabdomyolysis in Hemophilia A

Authors

Joseph A. Wilson¹, Stephanie Hayden², Alexander Asamoah³, Vivek R. Sharma⁴, David C. Jennings⁵, Ashok B. Raj^{6, *,}

¹Norton Children’s Hospital, University of Louisville, Louisville, KY, USA

²University of Louisville, Louisville, KY, USA

³Department of Pediatrics, Division of Pediatric Genetics and Genomics, Norton Children’s Hospital, University of Louisville, Louisville, KY, USA

⁴Department of Medicine, Division of Medical Oncology/Hematology, University of Louisville, Louisville, KY, USA

⁵Department of Radiology, Pediatric Radiology Department, Norton Children’s Hospital, Louisville, KY, USA

⁶Department of Pediatrics, Division of Pediatric Hematology/Oncology, Norton Children’s Hospital, University of Louisville, Louisville, KY, USA

^*Corresponding author. Email: ashok.raj@louisville.edu

DOI

10.2991/chi.k.200924.001How to use a DOI?

Keywords

Emicizumab; rhabdomyolysis; hemophilia A

Abstract

Emicizumab is increasingly the front-line treatment for patients with Hemophilia A with or without inhibitors. Rhabdomyolysis is a syndrome of muscle necrosis and release of intracellular muscle constituents into the circulation. Creatine kinase (CK) levels are typically markedly elevated, and muscle pain and myoglobinuria may be present. The severity of illness ranges from asymptomatic elevations in serum muscle enzymes to life-threatening disease associated with extreme enzyme elevations, electrolyte imbalances, acute kidney injury and disseminated intravascular coagulation. We present a case of an African American male with severe hemophilia A and history of factor VIII inhibitor, maintained on emicizumab prophylaxis, who developed rhabdomyolysis with a symptomatic hyperCKemia. To date, there is no known link between rhabdomyolysis to emicizumab. This report brings to light the possibility of symptomatic rhabdomyolysis as a potential side effect of emicizumab after moderate exertional activity.

Copyright

© 2020 International Academy for Clinical Hematology. Publishing services by Atlantis Press International B.V.

Open Access

This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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TY  - JOUR
AU  - Joseph A. Wilson
AU  - Stephanie Hayden
AU  - Alexander Asamoah
AU  - Vivek R. Sharma
AU  - David C. Jennings
AU  - Ashok B. Raj
PY  - 2020
DA  - 2020/10/07
TI  - Emicizumab Associated Rhabdomyolysis in Hemophilia A
JO  - Clinical Hematology International
SP  - 165
EP  - 167
VL  - 2
IS  - 4
SN  - 2590-0048
UR  - https://doi.org/10.2991/chi.k.200924.001
DO  - 10.2991/chi.k.200924.001
ID  - Wilson2020
ER  -