Case Reports
Vol. 19 No. 2 (2025)
A case report of bladder cancer-related acquired hemophilia A
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: 17 June 2025
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Acquired hemophilia A is an extremely rare (incidence of 1.5/1,000,000) and potentially life-threatening disorder characterized by the production of autoantibodies against coagulation factor VIII with a consequent increased bleeding risk; it mainly affects elderly people, and approximately 6-22% of the cases are cancer-related. We report the case of an 84-year-old man who presented with subcutaneous hematomas and anemia; he had prolonged activated partial thromboplastin time, coagulation factor VIII deficiency, and high levels of factor VIII antibodies, and he was successfully treated with prednisone, cyclophosphamide, and recombinant activated factor VII as a bypassing agent.
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Citations
Huth-Kuhne A, Baudo F, Collins P, et al. International recommendations on the diagnosis and treatment of patients with acquired hemophilia A. Haematologica 2009;94:566-75.
Collins PW, Hirsch S, Baglin TP, et al. Acquired hemophilia A in the United Kingdom: a 2-year national surveillance study by the United Kingdom Haemophilia Centre Doctors’ Organisation. Blood 2007;109:1870-7.
Tiede A, Klamroth R, Scharf RE, et al. Prognostic factors for remission of and survival in acquired hemophilia A (AHA): results from the GTH-AH 01/2010 study. Blood 2015;125:1091-7.
Collins P, Baudo F, Huth-Kühne A, et al. Consensus recommendations for the diagnosis and treatment of acquired haemophilia A. BMC Res Notes 2010;3:161.
Napolitano M, Siragusa S, Mancuso S, Kessler CM. Acquired haemophilia in cancer: a systematic and critical literature review. Haemophilia 2018;24:43-56.
Ryšánková K, Gumulec J, Grepl M, Krhut J. Acquired haemophilia as a complicating factor in treatment of non-muscle invasive bladder cancer: a case report. World J Clin Cases 2023;11:5338-43.
Collins P, Baudo F, Knoebl P, et al. Immunosuppression for acquired hemophilia A: results from the European Acquired Haemophilia Registry (EACH2). Blood 2012;120:47-5.
Tiede A, Collins P, Koeb P, et al. International recommendations on the diagnosis and treatment of acquired hemophilia. Haematologica 2020;105:1791-801.
Kreuter M, Retzlaff S, Enser-Weis U, et al. Acquired haemophilia in a patient with gram-negative urosepsis and bladder cancer. Haemophilia 2005;11:181-5.
Taza F, Suleman N, Paz R, Haas C. Acquired hemophilia A and urothelial carcinoma. J Community Hosp Intern Med Perspect 2021;11:89-93.
Onitilo AA, Skorupa A, Lal A, Ronish E et al. Rituximab in the treatment of acquired factor VIII inhibitors. Thromb Haemost 2006;96:84-7.
Tiede A, Worster A. Lessons from a systematic literature review of the effectiveness of recombinant factor VIIa in acquired haemophilia. Ann Hematol 2018;97:1889-901.
How to Cite
A case report of bladder cancer-related acquired hemophilia A. (2025). Italian Journal of Medicine, 19(2). https://doi.org/10.4081/itjm.2025.2019
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