Abstract

ALFARO-MURILLO, Alberto J.; DOBLES-RAMIREZ, Carlos  and  SALAS-SEGURA, Donato A.. Massive spontaneous bleeding. Acta méd. costarric [online]. 2017, vol.59, n.4, pp.164-166. ISSN 0001-6002.

A patient that presented with spontaneous hemorrhagic diathesis, with no apparent cause is presented. Hemorrhagic diathesis presents a wide range of diagnosis possibilities as of coagulation disorders are referred, in the context of a healthy patient with no previous major bleeding episodes and that debuts with massive hemorrhages. Acquired hemophilia, a little known disease, is one that must be considered.

Acquired hemophilia is an uncommon hemostasis disorder characterized by the presence of acquired inhibitors of coagulation factors in the plasma of the sick patient. These acquired inhibitors, are antibodies that could be alloantibodies or autoantibodies. Alloantibodies are developed in patients who have coagulation factor deficiency, in response to factor replacement therapy, thus complicating treatment.

On the other hand, autoantibodies are developed in people without previous defects and are specific against a factor of coagulation, affecting or not their function, obstructing one or several stages of the coagulation pathways. We report a case of acquired hemophilia due to an autoantibody against factor VIII in a 58 years old male patient with spontaneous massive bleeding.

Keywords : Hemorrhage; Factor VIII; plasmapheresis; spontaneous bleeding; acquired hemophilia.

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