A Case Report of a 80-Year-Old Woman with A Life-Threatening Hemorhage as a Result of Acquired Hemophilia

Acquired hemophilia (AH) is a bleeding disorder involving development of autoantibodies directed against plasma coagulation factors. It is a rare, but potentially life-threatening disease. Therefore, establishment of an early diagnosis with subsequent initiation of an appropriate treatment is crucial. Case report. We present a case of an 80-year-old woman with a clinical presentation of progressive ecchymosis and hematomas spread all over her body at the time of admission. The patient has not been taking anticoagulants or nonsteroidal anti-inflammatory drugs previously and both her medical and family history were negative for occurrence of a clotting disorder at any point before. Regarding the diagnosis, several coagulation studies have been performed including activated partial thromboplastine time (APTT), APTT mixing assay, clotting factors level and the Bethesda assay. The latter, confirmed the diagnosis of acquired hemophilia A. Consequently, appropriate immunosuppressive treatment with Cyclophosphamide and corticosteroids (Cyclophosphamide 200mg given on alternative days and Dexamethasone 8mg/daily) has been initiated. This resulted in apparent clinical improvement in two weeks.