clinmedКлиническая медицинаClinical Medicine (Russian Journal)0023-21492412-1339ООО «Медицинское информационное агентство»10.30629/0023-2149-2026-104-3-219-225clinmed-1425Research ArticleЗАМЕТКИ И НАБЛЮДЕНИЯ ИЗ ПРАКТИКИNOTES AND OBSERVATIONS FROM PRACTICEТрудности диагностики приобретенной гемофилии АDifficulties in diagnosing acquired hemophilia Ahttps://orcid.org/0000-0001-7938-1763КондратьеваТ. Б.KondratievaT. B.

Кондратьева Татьяна Борисовна — канд. мед. наук, доцент кафедры госпитальной терапии №1

Москва

Tatyana V. Kondratyeva — Candidate of Medical Sciences, Associate Professor of the Department of Hospital Therapy No. 1 

Moscow

https://orcid.org/0009-0008-4413-4752АвазнелиА. А.AvazneliA. A.

Авазнели Анна Анатольевна — студентка

Москва

Anna А. Avazneli — Student 

Moscow

https://orcid.org/0000-0002-2161-2140АгеевА. А.AgeevA. A.

Агеев Антон Александрович — канд. мед. наук, ассистент кафедры госпитальной терапии №1

Москва

Anton A. Ageev — Candidate of Medical Sciences, Assistant of the Department of Hospital Therapy No. 1 

Moscow

https://orcid.org/0000-0003-1453-7290ХлевчукТ. В.KhlevchukT. V.

Хлевчук Татьяна Васильевна — канд. мед. наук, доцент кафедры госпитальной терапии №1

Москва

Tatyana V. Khlevchuk — Candidate of Medical Sciences, Associate Professor of the Department of Hospital Therapy No. 1 

Moscow

khlevchuk@inbox.ruhttps://orcid.org/0000-0003-4802-6544АксеноваМ. Б.AksenovaM. B.

Аксенова Марианна Борисовна — канд. мед. наук, доцент кафедры госпитальной терапии №1

Москва

Marianna B. Aksenova — Candidate of Medical Sciences, Associate Professor of the Department of Hospital Therapy No. 

Moscow

ПоповР. Г.PopovR. G.

Попов Ростислав Григорьевич — студент

Москва

Rostislav G. Popov — Student of the Department of Hospital Therapy No. 1 

Moscow

КарповаП. А.KarpovaP. A.

Карпова Полина Андреевна — студентка

Москва

Polina A. Karpova — Student of the Department of Hospital Therapy No. 1 

Moscow

https://orcid.org/0000-0002-3496-6466ПоповаЛ. В.PopovaL. V.

Попова Людмила Викторовна — канд. мед. наук, доцент кафедры госпитальной терапии №1

Москва

Lyudmila V. Popova — Candidate of Medical Sciences, Associate Professor of the Department of Hospital Therapy No. 1

Moscow

ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Институт клинической медицины им. Н.В. СклифосовскогоРоссияI.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of the Russia (Sechenov University), Institute of Clinical Medicine named after N.V. SklifosovskyRussian Federation2026170520261043219225Copyright © Кондратьева Т.Б., Авазнели А.А., Агеев А.А., Хлевчук Т.В., Аксенова М.Б., Попов Р.Г., Карпова П.А., Попова Л.В., 20262026Кондратьева Т.Б., Авазнели А.А., Агеев А.А., Хлевчук Т.В., Аксенова М.Б., Попов Р.Г., Карпова П.А., Попова Л.В.Kondratieva T.B., Avazneli A.A., Ageev A.A., Khlevchuk T.V., Aksenova M.B., Popov R.G., Karpova P.A., Popova L.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.clinmedjournal.com/jour/article/view/1425

Приобретенная гемофилия А (ПГА) — редкое и опасное для жизни аутоиммунное заболевание, связанное с развитием ингибиторов к фактору свертывания VIII. В представленном клиническом наблюдении описан случай 82-летней пациентки с внутричерепным кровоизлиянием и множественными гематомами, у которой диагностирована ПГА. Диагноз подтвержден по данным коагулограммы, включающей удлинение АЧТВ и снижение активности фактора VIII до 3,5%. Проведенное лечение включало гемостатическую и иммуносупрессивную терапию с положительной динамикой. Наблюдение подчеркивает необходимость своевременной диагностики ПГА и индивидуального терапевтического подхода, особенно у пожилых пациентов без предшествующего геморрагического анамнеза. Представленный случай иллюстрирует сложности диагностики ПГА в условиях маскирующей клинической картины и показывает значимость междисциплинарного взаимодействия врачей различных специальностей.

Acquired hemophilia A (AHA) is a rare but life-threatening autoimmune disorder caused by the development of inhibitors against coagulation factor VIII. This article presents a clinical case of an 82-year-old female patient who was admitted with intracerebral hemorrhage and multiple spontaneous hematomas and was subsequently diagnosed with AHA. The diagnosis was confirmed by prolonged activated partial thromboplastin time (aPTT) and significantly decreased factor VIII activity level of 3.5%. The patient received hemostatic and immunosuppressive therapy with a positive clinical response. This case emphasizes the importance of early diagnosis and a personalized therapeutic approach, especially in elderly patients without a previous history of bleeding disorders. The observation illustrates the diagnostic challenges of AHA when masked by other clinical conditions and highlights the need for interdisciplinary collaboration among healthcare providers.

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The authors declare that there are no conflicts of interest present.