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Acquired Hemophilia A with Gastrointestinal Bleeding
Narae Park1, Jin Seok Jang1, Jae Hwang Cha1
1Division of Gastroenterology, Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.
Clinical Endoscopy
|July 8, 2019
Summary
Acquired hemophilia A, a rare bleeding disorder, can present with gastrointestinal bleeding. This case highlights a 78-year-old man with upper GI bleeding and psoas hematoma due to acquired hemophilia A.
Area of Science:
- Hematology
- Gastroenterology
Background:
- Peptic ulcer disease, variceal bleeding, Mallory-Weiss syndrome, and malignancy are common causes of acute gastrointestinal bleeding.
- Acquired hemophilia A is a rare hemorrhagic condition caused by autoantibodies against coagulation factor VIII, typically presenting with musculocutaneous bleeding.
Observation:
- A 78-year-old male presented with melena and symptoms of upper gastrointestinal bleeding.
- Esophagogastroduodenoscopy revealed Dieulafoy's lesions, treated endoscopically.
- Subsequent back pain and persistent GI bleeding symptoms led to the detection of a psoas muscle hematoma via CT scan.
Findings:
- Blood tests confirmed the presence of antibodies against coagulation factor VIII.
- The patient was diagnosed with acquired hemophilia A.
Implications:
- This case underscores that acquired hemophilia A, though rare, can manifest with gastrointestinal bleeding, including upper GI bleeding and associated hematomas.
- Early diagnosis of acquired hemophilia A is crucial for appropriate management of bleeding complications.
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