CC BY-NC-ND 4.0 · J Neurol Surg Rep 2022; 83(01): e19-e22
DOI: 10.1055/a-1759-9841
Case Report

Spontaneous Spinal Subdural Hematoma Secondary to Hemophilia A and Zanubrutinib

John Lynes
1   Department of Neuro-Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, United States
,
Sebastian Rubino
1   Department of Neuro-Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, United States
,
Andrea Rogers
1   Department of Neuro-Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, United States
,
Sameh Gaballa
3   Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, United States
,
Hien D. Liu
4   Department of Bone Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, United States
,
John A. Arrington
2   Department of Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, United States
,
Edwin Peguero
1   Department of Neuro-Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, United States
,
1   Department of Neuro-Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, United States
5   Department of Oncologic Sciences, University of South Florida Morsani College of Medicine,. Tampa, Florida, United States
› Author Affiliations

Abstract

Spontaneous spinal subdural hematomas (SSH) are rare occurrences that can occur most commonly secondary to vascular malformations or coagulopathies. Only a small fraction of spontaneous SSHs are caused by acquired coagulation disorders such as leukemia, hemophilia, and thrombocytopenia. This case report describes a patient with a history of Guillain–Barré syndrome (GBS), hemophilia A, and mantle cell lymphoma, on zanubrutinib therapy, a Bruton tyrosine kinase inhibitor associated with a risk of spontaneous hemorrhage. This patient developed a spontaneous spinal subdural hematoma, most likely due to the zanubrutinib therapy and exacerbated due to hemophilia. Treatment was delayed due to the patient's history of GBS that confounded the clinical diagnosis. This case is the first report of a spontaneous SSH in a patient on zanubrutinib, highlighting the need for a high index of suspicion for CNS hemorrhage in patients on Bruton's tyrosine kinase (BTK) inhibitor therapy.



Publication History

Received: 17 November 2021

Accepted: 11 January 2022

Accepted Manuscript online:
03 February 2022

Article published online:
14 March 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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