Acquired Hemophilia A: A Case Report

Abstract

Case Report A 61-year-old African American male, with a past medical history of asthma and benign prostatic hypertrophy, presented from an outside hospital with complaints of hematuria and hematemesis. He had initially noted increased bruising two months prior to admission. He also had symptoms suggestive of a non-traumatic thigh hematoma the month prior. He developed hematuria one month prior to admission and underwent an outpatient cystoscopy one week prior to admission which was non-diagnostic. Cystoscopy was repeated on the day of admission localizing the hemorrhage to his right kidney with a biopsy specimen suggesting a low-grade papillary neoplasm. The patient subsequently developed hemetemesis. Emergent esophagogastroduodenoscopy (EGD) at the outside hospital revealed a Mallory-Weiss tear. Epinephrine was injected with initial hemostasis. EGD was repeated after transfer due to recurrent hematamesis and clips were placed to control the hemorrhage. The patient experienced continued hematuria requiring repeat cystoscopy with laser ablation, as well as biopsy of the right ureter and right mid-pole infundibulum. However, multiple repeated biopsies failed to confirm the presence of malignancy.