Difficulties in diagnosing acquired hemophilia A

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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