Acquired haemophilia A: the importance of early recognition in cases of spontaneous bleeding in the elderly

Patel, Neeral; Wyrko, Zoe; Naqvi, Syeda; Croft, Adam P.

doi:10.1136/bcr-2014-206911

Cited by 4 publications

(4 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In total, 47 different pathologies were misdiagnosed, with two initially diagnosed as another pathology before being correctly diagnosed as cellulitis . The pathologies were grouped by specialty: vascular (nine pathologies) was the most common group . Necrotizing fasciitis, sarcoidosis, lymphoma and chemotherapy‐related pathology had the most case reports or series as a misdiagnosis.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

The red leg dilemma: a scoping review of the challenges of diagnosing lower‐limb cellulitis

et al. 2018

View full text Add to dashboard Cite

show abstract

Section: Resultsmentioning

confidence: 99%

“…Next, 533 full‐text articles were assessed for eligibility and 71 were included for data extraction (Fig. ) . Nine papers were foreign‐language texts: six French, two Spanish and one Turkish.…”

Section: Resultsmentioning

confidence: 99%

The red leg dilemma: a scoping review of the challenges of diagnosing lower‐limb cellulitis

et al. 2018

View full text Add to dashboard Cite

show abstract

“…To our knowledge, there is no specific guidance on the management of AHA in Jehovah’s Witnesses and no case reports published pertaining to the same. There are however a number of case reports detailing the diagnosis of AHA in the elderly population 11…”

Section: Discussionmentioning

confidence: 99%

Acquired haemophilia A in a patient who is a Jehovah’s Witness

Brown

Page²

2022

BMJ Case Rep

View full text Add to dashboard Cite

We detail the case of a man in his 80s who was a Jehovah’s Witness, presenting to hospital for the second time in 1 week with atraumatic, severe bruising affecting his right thigh and flank. He was subsequently diagnosed with idiopathic acquired haemophilia A (AHA) and was urgently treated with recombinant factor concentrate and immunosuppressive therapy. Management of his bleeding disorder and resultant severe anaemia was adapted in line with his religious beliefs. AHA is a rare bleeding disorder which should be considered in patients with an isolated prolonged activated partial thromboplastin time and a history of recent or acute bleeding. Prompt diagnosis and management are essential as delays may result in increased mortality. Given that this patient declined blood transfusion, management of his bleeding disorder presented a unique challenge.

show abstract

“…A meta-analysis of 249 cases after a median follow-up of 12 months showed a complete remission rate of 74% [ 11 ]. In the same study, poor prognostic factors were age >65 years, no remission, and the nature of the underlying disease, malignancy being the worst.…”

Section: Discussionmentioning

confidence: 99%

Could a Haematoma Be Due to an Acquired Phenomenon?

Zafar¹,

Manuel²,

Newman³

et al. 2021

Cureus

View full text Add to dashboard Cite

Acquired hemophilia, as opposed to congenital hemophilia, develops in individuals with no previous history of bleeding disorder with almost similar numbers of males and females affected. It is predominantly a disease of the elderly. It is an autoimmune disorder and occurs when the immune system produces antibodies that mistakenly attack healthy tissue, specifically the clotting factors, in particular clotting factor VIII. As a result, affected individuals develop abnormal uncontrolled bleeding into the muscles, soft tissues, and the skin and it can occur spontaneously during surgery, or following trauma, and potentially cause life-threatening bleeding complications in severe cases. The affected individuals may remain undiagnosed or be misdiagnosed, making it difficult to determine the actual frequency of the disorder in the general population. The clinical presentation should suspect it with confirmation by an abnormal coagulation test. Typical laboratory results with a recent onset of abnormal bleeding and an isolated prolongation of the activated partial thromboplastin time (APTT), especially in the elderly and peri- and post-partum women, should raise eyebrows. We present two cases following different symptomatology and emphasize the clinical challenges for junior medical doctors who receive patients on the front end. We hope to emphasize understanding simple coagulation blood results followed by a meaningful discussion with the hematology team towards appropriate and timely management of the bleeding diathesis. We hope this case series report will help junior medical doctors manage patients appropriately and consult with their hematology colleagues.

show abstract

Acquired haemophilia A: the importance of early recognition in cases of spontaneous bleeding in the elderly

Cited by 4 publications

References 16 publications

The red leg dilemma: a scoping review of the challenges of diagnosing lower‐limb cellulitis

The red leg dilemma: a scoping review of the challenges of diagnosing lower‐limb cellulitis

Acquired haemophilia A in a patient who is a Jehovah’s Witness

Could a Haematoma Be Due to an Acquired Phenomenon?

Contact Info

Product

Resources

About