Acquired hemophilia a presenting as a bleeding diathesis in a postpartum patient: diagnosis and management

Abstract

Antibodies against Factor VIII (FVIII) can develop in non-hemophiliac patients, causing the rare condition of acquired hemophilia. In 7.3% of the patients, the FVIII inhibitors appear either during pregnancy or in the postpartum period. In this case report, we present a non-hemophiliac patient, who presented five months postpartum with intermittent heavy vaginal bleeding, easy bruising, hemarthrosis, and recurrent frank hematuria. The woman presented to the emergency room with hematuria. Coagulation screening tests showed a prolonged APTT. Using a standard diagnostic algorithm, a Factor VIII inhibitor was detected. The treatment, cause of disease, and prognosis of this woman is presented in this paper as well as a literature review of acquired hemophilia A associated with pregnancy.