What question did this study set out to answer?

The aim is to highlight the occurrence of acquired hemophilia A in an elderly patient and discuss its management.

March 21, 2026Open Access

Severe Spontaneous Hematoma in an Elderly Female: A Case of Acquired Hemophilia A

Key Points

The aim is to highlight the occurrence of acquired hemophilia A in an elderly patient and discuss its management.
Described a case of an 87-year-old female with spontaneous bruising.
Diagnosed based on low coagulation factor VIII levels and elevated FVIII inhibitor levels.
Managed with recombinant activated factor VII, porcine FVIII, corticosteroids, and rituximab.
Reviewed diagnostic criteria and current treatment guidelines.
The patient showed clinical stabilization after treatment.
Diagnosis was confirmed with significantly low FVIII levels.
Treatment outcome indicated effectiveness of combined therapy approaches.

Abstract

Acquired Hemophilia A (AHA) is a rare but serious autoimmune disorder characterized by the development of autoantibodies against coagulation factor VIII (FVIII), leading to spontaneous bleeding in individuals without a personal or family history of bleeding disorders. The incidence of AHA is approximately 1.5 cases per million per year, with a higher prevalence in the elderly. This case report describes an 87-year-old female who presented with extensive bruising and was found to have profoundly low FVIII levels, and elevated FVIII inhibitor levels confirming a diagnosis of AHA. Management included recombinant activated factor VII (rFVIIa), porcine FVIII (Obizur), corticosteroids, and rituximab, leading to clinical stabilization. We also review diagnostic criteria, the role of inhibitor levels in monitoring, and current treatment guidelines, including the emerging role of emicizumab.

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