Acquired Hemophilia A: Three Cases and Review of the Literature

Background: Acquired hemophilia A (AHA) is an autoimmune disease caused by autoantibodies against coagulation factor VIII. It is a rare and potentially fatal and often underestimated pathology, mainly in the elderly person and for whom the rapidity of the diagnosis and the initiation of the background treatment are necessary. We reported three cases diagnosed in our hospital. Methods and Results: First case: A 55-year-old man, without personal or familial hemorrhagic case history. Admitted to the hospital with anemic and hemorrhagic cutaneous syndromes. His treatment included transfusion support, concentrate F VIIIa, and corticosteroids with good clinical evolution. Second case: An 82-year-old man, without case history, admitted with cutaneous mucosal hemorrhagic syndrome with hemorrhage of the puncture sites. Good evolution with treatment based on NovoSeven, corticosteroid, and cyclophosphamide in addition to transfusion support. Third case: A 52-year-old man, was followed for 3 years for pemphigoid. He was hospitalized for surgical treatment of an extensive and painful hematoma of the anterior aspect of the right leg following a fall and treated with corticosteroid and NovoSeven. Conclusions: Although rare, AHA must be diagnosed early, and may, at any time, commit to the vital prognosis by the appearance of serious hemorrhagic complications.