A Case of Unexplained Bleeding: Have You Considered Acquired Hemophilia?
Acquired hemophilia A is a rare but potentially life-threatening bleeding disorder caused by the development of autoantibodies directed against coagulation factors.1,2 Because this condition often presents in patients with no known bleeding disorder, emergency physicians are often the first to evaluate these patients.1 Prompt recognition and appropriate management of acquired hemophilia is therefore critical in reducing the risk of excessive bleeding and mortality.1
The following video sponsored by Novo Nordisk presents a unique case from one institution in which a woman with undiagnosed acquired hemophilia was seen by a dentist in the emergency department for uncontrolled bleeding following a tooth extraction. This case illustrates the symptoms of acquired hemophilia upon presentation in the emergency department, the tests that were ordered to efficiently obtain an accurate diagnosis, and the importance of collaboration of emergency physicians with hematologists experienced in managing acquired hemophilia. This video is not intended to be critical of the providers involved as we recognize the difficulty in treating patients with rare bleeding disorders. The work provided by emergency care providers is highly respected, and we hope this video will provide you with the knowledge to recognize the signs and symptoms of acquired hemophilia and steps to providing care for these patients.
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1. Kruse-Jarres R, Kempton CL, Baudo F, et al. Acquired hemophilia A: Updated review of evidence and treatment guidance. Am J Hematol. 2017;92(7):695-705.
2. Huth-Kühne A, Baudo F, Collins P, et al. International recommendations on the diagnosis and treatment of patients with acquired hemophilia A. Haematologica. 2009;94(4):566-575.