Acquired Hemophilia as Initial Presentation in a Patient with Systemic Lupus Erythematosus.

BACKGROUND: Acquired hemophilia is a rare bleeding disease which might be associated with some autoimmune diseases. Acquired hemophilia may be the result of autoantibodies against factor VIII.

CASE PRESENTATION: In this study, we describe a 55 year old patient who developed hematoma and hematuria due to acquired hemophilia secondary to systemic lupus erythematosus (SLE). Then, she developed arthritis and thrombosis after some evaluations. Laboratory data showed prolonged aPTT, normal PT and platelet, low FVIII, high FVIII inhibitor, ANA, anti-ds-DNA, and anticardiolipin. This patient was treated with corticosteroids, FEIBA and rituximab, so she recovered and was discharged about seven days later.

CONCLUSION: We should consider lupus erythematosus in patients with acquired hemophilia. Some cases of acquired hemophilia may be an SLE manifestation, so we should consider this situation to diagnose the disease properly.