Acquired hemophilia is a severe, potentially life-threatening condition usually involving elderly patients, caused by an auto-antibody against factor VIII of coagulation. We describe the case of a 92-years-old woman who came to our attention for severe acute anemia associated with many spontaneous diffuse skin bleedings secondary to a prolonged aPTT 110 sec, factor VIII < 1% with a titer of factor VIII inhibitor of 5.5 Bethesda Units. A diagnosis of chronic lymphocytic leukemia was determined. We treated the patient with a blood transfusion and intravenous corticosteroids with prompt reduction of aPTT and inhibitor factor VIII titer. The present case report involving a very old patient could represent an example of acquired hemophilia as a first manifestation of a lymphoproliferative syndrome.
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