A Patient with Acquired Hemophilia Developing after Colon Cancer

Abstract

Acquired hemophilia presents with bleeding symptoms. It occurs in individuals with no history of bleeding diatheses or any family history of hemophilia, and is caused by the appearance of inhibitors of clotting factors in the blood. Acquired hemophilia is an extremely rare disease, although cases are being reported more and more frequently.
An 83-year-old female had been discharged from the hospital after an uneventful postoperative course following laparoscopic right hemi-colectomy for ascending colon cancer. More than one month after the operation, she was diagnosed as having acquired hemophilia after she presented with hematomas in her upper right arm and examination of the coagulation profile revealed a prolonged activated partial thromboplastin time (APTT). Proper cancer treatment led to complete remission. Since this disease has a high fatality rate, treatment needs to be initiated before a definitive diagnosis can be established. This disease is most frequently encountered in older people, and patients with autoimmune disorders or malignant tumors account for over a half of the patients. In cases presenting with bleeding of unknown cause and prolongation of the APTT, acquired hemophilia needs to be ruled out.