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Acquired haemophilia A associated to autoimmune thyroiditis and pangastritis
  1. Joana Isabel Marques Dias,
  2. Marta Azevedo Ferreira,
  3. Ana Grilo and
  4. Ana Isabel Reis
  1. Internal Medicine, Hospital Beatriz Angelo, Loures, Lisboa, Portugal
  1. Correspondence to Joana Isabel Marques Dias; joana.marques.dias92{at}gmail.com

Abstract

Acquired haemophilia A is a rare condition defined by the presence of coagulation inhibitors, which are autoantibodies directed against factor VIII that interfere with its activity. We report a case of a 69-year-old woman that presented with knee haemarthrosis followed by spontaneous retroperitoneal haematoma. On coagulation studies, she presented normal prothrombin time with prolonged activated partial thromboplastin time non-correcting on mixture test, low titers of factor VIII and was detected factor VIII inhibitor that led to diagnosis of acquired haemophilia A. She was managed with supportive measures to control haemorrhage and immunosuppressive therapy to eradicate inhibitors, initially with corticosteroids, with partial transitory response, after which she developed new spontaneous haematomas. Rituximab was started at that time, with a good outcome. The additional aetiological study identified autoimmune thyroiditis and autoimmune pangastritis, an association rarely described in literature.

  • Immunology
  • Haematology (incl blood transfusion)
  • Thyroiditis

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Footnotes

  • Contributors The patient was admitted to the hospital and during her stay the department of internal medicine was responsible for diagnosis and treatment—AG, AIAR. There was an ongoing contact with the immunotherapy department of Hospital Beatriz Ângelo. As an outpatient, the follow-up was maintained in internal medicine—JMD, MAF, AG.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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