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Acquired haemophilia A: an unusual postoperative complication
  1. Sumant Arora1,
  2. Gaurav Goyal2,
  3. Rehan Sarmad3,
  4. Kenneth J Wool1
  1. 1University of Alabama School of Medicine, Montgomery, Alabama, USA
  2. 2Department of Hematology/Oncology, Mayo Clinic Rochester, Minnesota, USA
  3. 3University of Alabama at Birmingham, Birmingham, Alabama, USA
  1. Correspondence to Dr Gaurav Goyal, goyal.gaurav{at}


An African-American man aged 65 years with multiple malignancies in remission was admitted for small bowel obstruction. He was treated with laparotomy following failure of conservative management. Postoperatively, he developed intra-abdominal bleed, which persisted, despite surgical haematoma evacuation. Further haematological workup revealed isolated prolongation of activated partial thromboplastin time (aPTT) with reduced factor VIII (FVIII) activity and raised FVIII inhibitor titre. Assuming acquired haemophilia A (AHA), FVIII inhibitor bypassing activity and corticosteroids were started with subsequent resolution of the bleeding from the surgical site. The patient remained free of bleeding episodes at 3-month follow-up and the aPTT normalised. This case report highlights the association of surgery with AHA and summarises the treatments with underlying mechanisms.

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  • Contributors SA, GG and RS wrote the manuscript draft. KJW reviewed and provided input. Final draft was reviewed by all authors.

  • Competing interests None declared.

  • Patient consent Obtained.

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