Postpartum-Acquired Hemophilia A Presenting as Hemoperitoneum: A Case Report

Azam, Khalid; Batool, Zainab; Malik, Ayesha; Chaudhry, Manahil; Abdullah, Mohammad

doi:10.7759/cureus.11817

Cited by 4 publications

(3 citation statements)

References 11 publications

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“…Clinically, AHA cases in pregnancy mostly appear incidentally with an unexpected high aPTT level, suggesting a problem in the intrinsic pathway mentioned earlier [ 9 ]. Most data to date have been extracted from European Acquired Hemophilia (EACH2) Registry.…”

Section: Discussionmentioning

confidence: 99%

Acquired Hemophilia A in Peripartum Period: Diagnostic and Therapeutic Dilemma

Waqar¹,

Khoury²,

Hussain³

et al. 2021

Cureus

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Acquired hemophilia A (AHA) is a bleeding diathesis caused by auto-antibody generation against factor VIII, an essential component of the coagulation cascade. Although having many etiologies, pregnancy is also one of the conditions associated with AHA. It mostly presents as a raised activated partial thromboplastin time (aPTT), and during the peripartum and postpartum period, concern for AHA should be raised as delays in diagnosis can be detrimental. Herein, we present a case of a 31-year-old female with sickle cell trait who developed venous bleeding and, later, neuraxial, musculoskeletal, and subcutaneous bleeding. She underwent an extensive course of treatment before getting into remission.

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Section: Discussionmentioning

confidence: 99%

Acquired Hemophilia A in Peripartum Period: Diagnostic and Therapeutic Dilemma

Waqar¹,

Khoury²,

Hussain³

et al. 2021

Cureus

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show abstract

“…Vaginal bleeding could be the presenting symptom if the inhibitor appears early in the course, so it is usually misdiagnosed by an obstetrician especially with no previous bleeding or family history in presented females with postpartum unexplained bleeding. Intraplacental transfer of antibodies and intracerebral hemorrhage in neonates are reported in few cases [ 19 ].…”

Section: Main Textmentioning

confidence: 99%

Acquired hemophilia A (AHA): underreported, underdiagnosed, undertreated medical condition

2022

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Background Acquired hemophilia A (AHA) is a rare acquired bleeding disorder occurred due to the formation of inhibitory antibodies neutralizing endogenous factor VIII. Main body About half the cases are idiopathic. Symptoms include severe and unexpected bleeding that could be life-threatening. High index of suspicion should be raised when unexplained subcutaneous or post-surgical bleeding with isolated prolonged APTT. Conclusions Acquired hemophilia A is a rare underdiagnosed underreported acquired hemostatic disorder that presents with sudden usually life-threatening bleeding; it is crucial to raise awareness and suspicion index of clinicians for early diagnosis and treatment to avoid morbidity and mortality.

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“…There were other primigravid cases where the patient developed acquired factor VIII inhibitors, but symptoms did not manifest until 2–9 months postpartum [ 4 , 12 , 15 , 22 ]. Still, there were cases of acquired factor VIII deficiency in women after their second pregnancy [ 14 , 17 ] and third pregnancy [ 4 ]. There did not seem to be any correlation with the gravid status of the patient and clinical outcomes.…”

Section: Literature Reviewmentioning

confidence: 99%

Acquired Factor VIII Deficiency Presenting as Gross Hematuria in a Hispanic, Pregnant Patient with Previously Undiagnosed Connective Tissue Disease

Loftis

Dulgheru

White

2021

Case Reports in Rheumatology

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Acquired factor VIII deficiency is a bleeding disorder caused by the presence of autoantibodies against clotting factor VIII. We report a case of a 24-year-old pregnant woman who presented with gross hematuria secondary to acquired factor VIII deficiency in the presence of a previously undiagnosed connective tissue disease. This article includes a literature review of pregnancy-related cases of acquired factor VIII deficiency. We also reviewed various therapeutic approaches for the management of the acquired factor inhibitor which include achieving hemostasis and elimination of the inhibitor via immunosuppressive agents. This case report describes the rare presentation of acquired factor VIII deficiency related to pregnancy and highlights the importance of considering a factor VIII inhibitor in the differential diagnosis of patients who present with bleeding and prolonged PTT during the peripartum and postpartum periods.

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Postpartum-Acquired Hemophilia A Presenting as Hemoperitoneum: A Case Report

Cited by 4 publications

References 11 publications

Acquired Hemophilia A in Peripartum Period: Diagnostic and Therapeutic Dilemma

Acquired Hemophilia A in Peripartum Period: Diagnostic and Therapeutic Dilemma

Acquired hemophilia A (AHA): underreported, underdiagnosed, undertreated medical condition

Acquired Factor VIII Deficiency Presenting as Gross Hematuria in a Hispanic, Pregnant Patient with Previously Undiagnosed Connective Tissue Disease

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