Acquired Factor VIII Deficiency Presenting as Compartment Syndrome

Compartment syndrome of the upper extremity is a surgical emergency that most often presents after an identifiable event, such as a crush injury, a closed fracture, a snake bite, reperfusion after embolectomy, an electrical injury, or a circumferential burn.

We report an unusual case in which an older woman was diagnosed with acquired factor VIII deficiency after presenting with acute nontraumatic compartment syndrome in her right upper extremity. Emergency medicine, plastic surgery, internal medicine, hematology, and hand therapy specialists worked together to identify the pathology and successfully treat the patient.

An isolated elevated partial thromboplastin time level in a patient who is bleeding should raise suspicions for factor VIII deficiency and immediately trigger further evaluation. Once this diagnosis is suspected, multidisciplinary treatment is indicated for immediate and long-term successful outcomes.