When coagulation fails in the oldest: Acquired hemophilia caused by chronic lymphocytic leukemia in a 92-years-old woman

Authors: Masotti, Luca¹; Vecce, Roberto¹; Gianchecchi, Daniele¹; Cantini, Roberto¹; Cannistraro, Daniela¹; Matteucci, Angela²; Cecconi, Nadia³

Source: Geriatrics and Gerontology International, Volume 5, Number 2, June 2005 , pp. 135-137(3)

Publisher: Wiley-Blackwell

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Abstract:

Acquired hemophilia is a severe, potentially life-threatening condition usually involving elderly patients, caused by an auto-antibody against factor VIII of coagulation. We describe the case of a 92-years-old woman who came to our attention for severe acute anemia associated with many spontaneous diffuse skin bleedings secondary to a prolonged aPTT 110 sec, factor VIII < 1% with a titer of factor VIII inhibitor of 5.5 Bethesda Units. A diagnosis of chronic lymphocytic leukemia was determined. We treated the patient with a blood transfusion and intravenous corticosteroids with prompt reduction of aPTT and inhibitor factor VIII titer. The present case report involving a very old patient could represent an example of acquired hemophilia as a first manifestation of a lymphoproliferative syndrome.

Keywords: acquired haemophilia; coagulation; chronic lymphatic leukaemia; elderly; factor VIII deficiency

Document Type: Case report

DOI: http://dx.doi.org/10.1111/j.1447-0594.2005.00283.x

Affiliations: 1: Internal Medicine, Cecina Hospital, and 2: Clinical Pathology, Livorno Hospital, Livorno, and 3: Department of Oncology, Division of Hematology, Santa Chiara Hospital, University of Pisa, Pisa, Italy

Publication date: 2005-06-01