Acquired Hemophilia A after Multiple Transfusions Following Trauma

Authors: Hidalgo, KG.; Azani, DZ.; Fincher, R; McCague, A.

Affiliations: Clinical Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, USA. Surgery, Desert Regional Medical Center, Palm Springs, USA. Trauma, Desert Regional Medical Center, Palm Springs, USA. Trauma and Acute Care Surgery, Desert Regional Medical Center, Palm Springs, USA.

Publication: Cureus. 2023. 15. e50295

ABSTRACT: Acquired hemophilia A (AHA) is a coagulative disorder that is caused by the presence of inhibitors of factor VIII (FVIII). The presence of coagulation factor inhibitors can lead to severe episodes of bleeding in patients with no previous history of bleeding conditions. We present the clinical case of a man with severe bleeding two weeks after falling from a bicycle. The patient denied any previous history of bleeding disorders. The case clinically presented with a large retroperitoneal hematoma and continued to show signs of active bleeding even after multiple transfusions were administered. Coagulation studies showed an elevated inhibitor titer of 24.4 BU/mL (normal range is below 5 BU/mL) and a reduced FVIII activity level of 2% (normal range is between 50% to 150%), providing evidence of AHA. Hemostatic and immunosuppressive agents were then administered to the patient, whose condition improved in response to the treatments.