Acquired Postpartum Hemophilia A: About 3 Cases

Abstract

Introduction: Acquired hemophilia A (AHA) is a rare but severe autoimmune disorder. It is caused by the acquisition of autoantibodies to factor VIII (FVIII). These post-partum autoantibodies account for 7-21% of all cases of AHA and most often develop after the first pregnancy. We report 3 new cases of postpartum-acquired hemophilia A. Observations: Three young women with no prior pathological history presented with a spontaneous and heterogeneous hemorrhagic syndrome, two cases of deep hematomas, and haematuria with ecchymosis in the 3rd patient. The diagnosis was made in all our patients based on plasma FVIII activity <50% and the presence of an FVIII inhibitor. Immunological tests and neoplastic research were negative in all our patients. Hemostatic treatment combined with corticosteroid therapy and immunosuppressive drugs were used for the 3 patients. Conclusion: AHA is a rare disease, and its diagnosis is often underestimated in our population. It is essential to make clinicians aware of this pathology and to be able to evoke it in young patients of childbearing age. A relapse is possible in future pregnancies, so long-term follow-up is recommended.