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- Title
New onset of acute heavy menstrual bleeding in a 34-year-old woman.
- Authors
Khalife, Roy; Duffett, Lisa; Wang, Tzu-Fei; Tinmouth, Alan
- Abstract
In acquired hemophilia A, factor VIII levels are typically substantially reduced to below 0.05 IU/mL (5%), but levels between 0.05 and 0.50 IU/mL have also been implicated in bleeding events.[7],[8] Our patient presented with bleeding after hemostatic challenges (i.e., ruptured ovarian cysts, postsurgical bleeding and menstrual flow), which would be expected in patients with mildly decreased factor VIII levels. Discussion Acquired hemophilia A is a rare bleeding disorder caused by autoantibodies that inhibit the function of factor VIII.[4],[5] The incidence is about 1 to 1.5 cases per million, with a median age of 64 years, affecting men and women equally.[5],[7] Acquired hemophilia A is a medical emergency requiring prompt recognition and treatment, especially in a bleeding patient. The patient's symptoms of recent onset bleeding from multiple causes (i.e., hemorrhagic ovarian cyst, postsurgical bleeding, new menorrhagia and abnormal ecchymosis) are suggestive of an acquired bleeding diathesis.
- Subjects
VON Willebrand disease; MENSTRUATION; BLOOD coagulation factor VIII antibodies; PLASMA products; BLOOD coagulation factor VIII; HEMOPHILIA
- Publication
Canadian Medical Association Journal (CMAJ), 2021, Vol 193, Issue 30, pE1173
- Publication type
journal article
- DOI
10.1503/cmaj.210169