Acquired Hemophilia A Masquerading as Bleeding on Anticoagulation: A Case Report Including Key Laboratory Considerations.
anticoagulants
blood coagulation tests
hematoma
hemophilia a
partial thromboplastin time
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
Jun 2023
Jun 2023
Historique:
accepted:
26
06
2023
medline:
31
7
2023
pubmed:
31
7
2023
entrez:
31
7
2023
Statut:
epublish
Résumé
We report a case of a patient with recurrent hematomas while on anticoagulation for a pulmonary embolism and a prolonged hospital stay due to a delayed diagnosis for acquired hemophilia A. Acquired hemophilia A is a rare autoimmune bleeding disorder with autoantibodies directed against coagulation factor VIII (FVIII), leading to an acquired FVIII deficiency. A prolonged isolated activated partial thromboplastin time (aPTT) in a bleeding patient warrants workup for acquired hemophilia A. This is specifically challenging in patients with thrombosis on anticoagulation and can lead to significant delays in diagnosis and associated morbidities. The case highlights the need for further awareness of this disease, potential laboratory pitfalls when conducting and interpreting coagulation assays, and the management considerations in a patient with a simultaneous thrombotic and hemorrhagic condition.
Identifiants
pubmed: 37519483
doi: 10.7759/cureus.41029
pmc: PMC10373513
doi:
Types de publication
Case Reports
Langues
eng
Pagination
e41029Informations de copyright
Copyright © 2023, MacNeill et al.
Déclaration de conflit d'intérêts
The authors have declared financial relationships, which are detailed in the next section.
Références
J Thromb Haemost. 2018 Dec;16(12):2362-2374
pubmed: 30264916
Hematol Oncol Clin North Am. 2021 Dec;35(6):1131-1142
pubmed: 34535289
Hemasphere. 2019 Sep 17;3(4):e286
pubmed: 31942541
J Thromb Haemost. 2017 Jul;15(7):1386-1391
pubmed: 28440008
Am J Clin Pathol. 2003 Jul;120(1):34-9
pubmed: 12866370
Am J Hematol. 2017 Jul;92(7):695-705
pubmed: 28470674
Chest. 2017 Jan;151(1):127-138
pubmed: 27637548
J Med Case Rep. 2020 Oct 30;14(1):206
pubmed: 33121522
Haemophilia. 2015 Mar;21(2):162-170
pubmed: 25623166
Haemophilia. 2007 May;13(3):317-22
pubmed: 17498082
PLoS One. 2015 Jan 27;10(1):e0116835
pubmed: 25625201
Semin Thromb Hemost. 2012 Oct;38(7):735-41
pubmed: 22941793
Blood Adv. 2018 Nov 27;2(22):3257-3291
pubmed: 30482765
Blood. 2021 Jan 21;137(3):410-419
pubmed: 32766881
J Thromb Haemost. 2020 Jan;18(1):36-43
pubmed: 31448877
Res Pract Thromb Haemost. 2018 Aug 18;2(4):689-695
pubmed: 30349888
Thromb Res. 2012 Dec;130(6):956-66
pubmed: 23006523
Haemophilia. 2018 Mar;24(2):186-197
pubmed: 29446525
Drugs Aging. 1995 Jan;6(1):45-54
pubmed: 7696778