Acquired hemophilia

Acquired hemophilia
Updated: 07/25/2023
© Jun Wang, MD, PhD

General features
  • Rare but potentially life-threatening bleeding disorder
  • Associated with autoimmune disorders, solid tumors, hematologic malignancies, dermatologic disorders, inflammatory bowel disease, respiratory diseases, diabetes, acute hepatitis (B and C), severe drug reactions, post-childbirth, or previous usage of coagulation factors
Clinical presentations
  • Bleeding
  • Hemarthrosis uncommon
Key pathogenesis
  • Autoantibodies (inhibitors) directed against plasma coagulation factors
  • Most frequently factor VIII (FVIII)
Key laboratory findings
  • Prolonged aPTT NOT reversed on a mixed study
  • Reduced FVIII levels and evidence of an FVIII inhibitor
  • Normal PT, platelet count
Treatment
  • Treat underlying disorder
  • Desmopressin in very low titer inhibitors
  • High-dose Factor VIII is low titer inhibitors
  • Recombinant Factor VIIa for severe bleeding


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