An unusual cause of bruising in an 80-year-old woman.
METHODS
a previously fit 80-year-old woman presented with a 2-week history of spontaneous and extensive bruising affecting all four limbs. The severity was such that she required a transfusion of 8 units of blood.
a markedly prolonged activated partial thromboplastin time which was only partially corrected with normal plasma; tests for lupus anticoagulant were negative. Factor VIII levels were reduced and the Bethesda assay indicated an acquired inhibitor to factor VIII. She was treated with a combination of intravenous immunoglobulin and immunosuppression.


RESULTS
the response to treatment was excellent, with a marked reduction in anti-factor VIII antibody levels and resolution of the bruising over the next few weeks.
Kelly
J
J
Department of Medicine for the Elderly, Queen Mary's Hospital, Sidcup, Kent, UK.
Gattens
M
M
Geraghty
R
R
D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000276:immunology*; D001327:Autoimmune Diseases / Q000209:etiology* / Q000276:immunology / Q000628:therapy; D003288:Contusions / Q000209:etiology* / Q000276:immunology / Q000628:therapy; D005169:Factor VIII / Q000037:antagonists & inhibitors* / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016896:Treatment Outcome
D001323:Autoantibodies; D005169:Factor VIII