Appiah John K, Ubanatu Chukwunonso B, Desai Karna, Asante Richeal, Bin Khalid Haider
Internal Medicine, Geisinger Health System, Wilkes-Barre, USA.
Cureus. 2025 May 26;17(5):e84820. doi: 10.7759/cureus.84820. eCollection 2025 May.
Acquired hemophilia A (AHA) is a rare but potentially life-threatening autoimmune bleeding disorder characterized by autoantibodies against factor VIII. It often presents with spontaneous bleeding in patients without a personal or family history of coagulopathy, making diagnosis particularly challenging. We present a case of a 60-year-old male with a remote history of right total hip arthroplasty (THA) who developed a spontaneous intra-articular hematoma, initially mistaken for a periprosthetic infection. He later re-presented with expanding ecchymosis and anemia, ultimately diagnosed with AHA following hematology evaluation. This case highlights the diagnostic pitfalls and emphasizes the importance of considering acquired coagulopathies in unexplained bleeding.
获得性血友病A（AHA）是一种罕见但可能危及生命的自身免疫性出血性疾病，其特征是存在针对凝血因子VIII的自身抗体。它常表现为在没有个人或家族凝血病病史的患者中出现自发性出血，这使得诊断极具挑战性。我们报告一例60岁男性病例，该患者有右侧全髋关节置换术（THA）的既往史，出现了自发性关节内血肿，最初被误诊为假体周围感染。他后来再次就诊，出现瘀斑扩大和贫血，血液学评估后最终诊断为AHA。该病例突出了诊断中的陷阱，并强调了在不明原因出血时考虑获得性凝血病的重要性。
