Congenital hemophilia is well known, but acquired hemophilia caused by autoimmune disorder is rare. We treated a 76-year-old woman with a hematoma in her soft palate and hypopharynx. The patient visited the hospital complaining of dysphagia and was found to have a hematoma in the throat. As a hematoma in this position can be extremely risky, we performed tracheostomy and obtained a biopsy specimen from the palate. The biopsy revealed no evidence of tumor, but blood examination revealed a coagulation disorder; the patient also had a large hematoma in her right buttock. On the basis of these findings, we diagnosed the patient as having acquired hemophilia A and started her on treatment with coagulation factor VIII. As enough response was not seen to this treatment, we added prednisolone and cyclophosphamide. With this treatment, the hematomas gradually resolved and we could close her tracheal stoma. Patients with acquired hemophilia are prone to repeated and severe bleeding, and severe bleeding or hematoma in the throat carries the risk of suffocation. Therefore, we should consider the possibility of hemophilia if severe hematoma formation is seen in the elderly.
