Acquired Hemophilia A Post-COVID-19 Vaccination: A Case Report and Review.

Hussam Al Hennawi,Sami J Shoura,Henry I Zaleski,Abdulrahman Taftafa,Mohamad Bakir,Abdul Rahman R Barakeh,Talal N Almasri,Feras Jazaeri,Mohidin Barazi,Mohammad K Al Masri,Muhammad K Khan

doi:10.7759/cureus.21909

Abstract

Acquired hemophilia A (AHA) is an inhibitory coagulopathy that represents a rare variant of hemorrhagic syndromes. We present a case of idiopathic AHA in a 75-year-old male patient with a cutaneous hematoma that could be attributed to a recent COVID-19 vaccination. The aim of this report is to raise awareness of a possible association between AHA and COVID-19 vaccination and to review similar reported cases and management plans to prevent the development of possible morbidity and debilitating complications. This case illustrates an exceptionally rare side effect of the COVID-19 vaccination. The advantages of obtaining the COVID-19 vaccine outweigh the risks.

Highlights

Hemophilia is the most prevalent and severe hemorrhagic disorder [1]
We present a case of acquired hemophilia A” (AHA) following the COVID-19 vaccination
The patient underwent further laboratory studies consisting of factor VIII activity that showed a severely low level of less than 1%, an extremely elevated Bethesda assay of 318 Bethesda units (BU), normal von Willebrand factor antigen level, and a 1:1 mixing study which failed to correct elevated activated partial thromboplastin time (aPTT)

Summary

Introduction

Hemophilia is the most prevalent and severe hemorrhagic disorder [1]. Hemophilia can be hereditary or acquired, with the latter occurring less frequently. The condition ranges from lifethreatening hemorrhage at one end of the spectrum to mild or no bleeding at the other, and the onset of life-threatening bleeding is most common during the first few weeks after developing the condition It can occur at any time if not managed appropriately [3,4,5]. On physical examination, affected patients may present with widespread spontaneous subcutaneous hematomas, without a precipitating factor [4] The rarity of this condition may account for the considerable delay in the diagnosis, so a thorough physical examination along with the necessary laboratory tests should be performed when the history reveals an etiological cause [1]. We present a case of AHA following the COVID-19 vaccination

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