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Case Reports: Reminder of important clinical lesson
Acquired haemophilia A in a patient who is a Jehovah’s Witness
  1. Clare Brown and
  2. Andrew Page
  1. Department of Haematology, Royal Infirmary of Edinburgh, Edinburgh, Scotland
  1. Correspondence to Dr Clare Brown; clarebrown3{at}hotmail.co.uk

Abstract

We detail the case of a man in his 80s who was a Jehovah’s Witness, presenting to hospital for the second time in 1 week with atraumatic, severe bruising affecting his right thigh and flank. He was subsequently diagnosed with idiopathic acquired haemophilia A (AHA) and was urgently treated with recombinant factor concentrate and immunosuppressive therapy. Management of his bleeding disorder and resultant severe anaemia was adapted in line with his religious beliefs. AHA is a rare bleeding disorder which should be considered in patients with an isolated prolonged activated partial thromboplastin time and a history of recent or acute bleeding. Prompt diagnosis and management are essential as delays may result in increased mortality. Given that this patient declined blood transfusion, management of his bleeding disorder presented a unique challenge.

  • Haematology (drugs and medicines)
  • Ethics
  • Haematology (incl blood transfusion)

https://doi.org/10.1136/bcr-2021-244928

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    Footnotes

    • Contributors CB was responsible for conception and design of the report, acquisition of data and interpretation of data. She drafted the report and is a guarantor. AP revised the draft report critically for intellectual content, was responsible for interpretation of data and is a guarantor.

    • 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.