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Case Reports
. 2024 Sep 3;16(9):e68549.
doi: 10.7759/cureus.68549. eCollection 2024 Sep.

Unravelling Acquired Hemophilia A in an Ambiguous Clinical Picture

Fathima Shehnaz Ayoobkhan  1 , Dakshin S Padmanabhan  1 , Rula Mahayni  2 , Sara Riaz  3 , Geetha Krishnamoorthy  1
Affiliations
Case Reports

Unravelling Acquired Hemophilia A in an Ambiguous Clinical Picture

Fathima Shehnaz Ayoobkhan et al. Cureus. .

Abstract

Acquired hemophilia A (AHA) is characterized by the development of neutralizing autoantibodies, called "inhibitors," against intrinsic factor VIII. Its presentation differs profoundly from congenital hemophilia. Here, we present the case of a 69-year-old patient presenting with right-sided flank pain and hematuria, initially diagnosed with acute pyelonephritis, who was found to have bilateral renal hemorrhage during the course of his hospitalization. Later, after a thorough diagnostic evaluation, he was deemed to have AHA.

Keywords: acquired hemophilia a (aha); cydri regimen; factor viii activity; factor viii inhibitor assay; renal hemorrhage.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. CT abdomen/pelvis showing initial right renal hemorrhage with right hydronephrosis (arrow)
Figure 2
Figure 2. CT abdomen/pelvis on later presentation showing left renal hemorrhage and hydronephrosis (arrows)
Figure 3
Figure 3. Sequence of events that led to the final diagnosis of acquired hemophilia A
Image created with BioRender software.
See this image and copyright information in PMC

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