Acquired hemophilia A (AHA) is a rare bleeding disorder that can be accompanied by challenges in diagnosis and management when there is a concurrent lupus anticoagulant. A 72‐year‐old male with no bleeding or thrombotic history presented with new spontaneous hematomas of the extremities and an isolated severely prolonged aPTT. Collaboration between hematology and coagulation laboratory specialists resulted in timely diagnosis and optimized assay interpretation in the setting of concomitant AHA and a previously unknown lupus anticoagulant. Emicizumab was beneficial in the successful treatment of AHA in the presence of a lupus anticoagulant. Concurrent AHA and lupus anticoagulant cases are rare and present diagnostic and management challenges that can be optimized with interdisciplinary collaboration.
Williamson et al. (Thu,) studied this question.