[Acquired hemophilia A developing at bilateral renal bleeding: a case report]

Area of Science:

• Nephrology
• Hematology
• Oncology

Background:

• Elderly patients presenting with asymptomatic gross hematuria require thorough investigation.
• Renal pelvic tumors can mimic other pathologies, necessitating comprehensive diagnostic workups.

Observation:

• An 82-year-old woman with asymptomatic gross hematuria was initially diagnosed with right renal pelvic carcinoma.
• Post-nephroureterectomy, she developed retroperitoneal hematoma, endotoxic shock, and left renal bleeding.
• Diagnosis of acquired hemophilia A was confirmed by low factor VIII activity and presence of inhibitors.

Findings:

• Histopathology revealed no malignancy but extensive hemorrhage and hematoma.
• Acquired hemophilia A presented as a rare complication following surgery for suspected renal pelvic carcinoma.
• The patient succumbed to postrenal renal failure 37 days post-operation.

Implications:

• This case highlights the critical importance of considering acquired hemophilia A in patients with unexplained bleeding, especially post-operatively.
• Early diagnosis and management of acquired hemophilia A are crucial for improving patient outcomes.
• This report adds to the limited global literature on acquired hemophilia A presenting with renal bleeding.