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Acquired hemophilia type A in the intensive care unit. Case reports
Luis Alejandro Sánchez-Hurtado1, Otoniel Toledo-Salinas2, Antonio Landaverde-López3
1Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades "Dr. Bernardo Sepúlveda Gutiérrez", Unidad de Cuidados Intensivos, Ciudad de México.
Background:
Acquired hemophilia type A (AHA) is a rare and deadly condition. It is caused by autoantibodies to factor VIII. It is a diagnostic and therapeutic challenge with the potential development of complications, which can put at risk the life of the person presenting it.
Case Reports:
We present two cases of patients that have bleeding and bleeding disorders, with the diagnosis of AHA diagnosed by activated partial thromboplastin time prolonged in isolated form, late correction with plasma, presence of factor VIII inhibitor of coagulation and decreased activity of factor VIII. The first case had a neoplasm and the second was in the puerperium, as risk factors. The severity of the condition and the risk of complications and/or death make it necessary to receive care in an intensive care unit.
Conclusions:
AHA is a rare clinical condition with high mortality. In patients in critical condition with persistent hemorrhage and alterations in the coagulation tests, it should be considered as part of the differential diagnosis. The management of this entity is multidisciplinary, and hemostatic and immunosuppressive treatments must be provided early.
