2023 年 46 巻 1 号 p. 42-46
A 63–year–old man developed a delayed intraorbital subperiosteal hematoma after a head trauma. Hemostasis was difficult despite using fresh frozen plasma, surgery, and transarterial embolization. Therefore, he was diagnosed with acquired hemophilia A (AHA) based on prolonged activated partial thromboplastin time (APTT), factor VIII activity (<1%), and the factor VIII inhibitor (6 BU/ml). Hemostasis was achieved through bypass therapy, involving recombinant activated factor VII, after which the resolution of autoantibodies was achieved through immunosuppressive therapy using corticosteroids. Although AHA is a rare, it is a potentially fatal bleeding disorder; hence early diagnosis and treatment are crucial. Therefore, it is important to suspect the syndrome when patients present with clinical findings suggestive of coagulation abnormalities, such as persistent bleeding despite appropriate treatment, average platelet count, normal prothrombin time, and prolonged APTT.
