title: Acquired hemophilia first manifesting as life-threatening intracranial hemorrhage: case report.
abstract: A 74-year-old man presented with life-threatening intracranial hemorrhage and prolonged activated partial thromboplastin time (APTT). The massive subdural hematoma was removed, but multiple intracranial hemorrhages occurred despite the administration of factor VIII and factor IX concentrates. Subdural hematoma, intracerebral hemorrhage in the left temporal lobe, and thalamic hemorrhage subsequently occurred with further prolongation of APTT. He died of enlargement of the thalamic hemorrhage. Acquired hemophilia was diagnosed caused by factor VIII inhibitor. Acquired hemophilia may cause life-threatening hemorrhage, and should be considered in patients with intracranial hemorrhages associated with unexplained prolongation of APTT.
authors.affiliation: Department of Neurosurgery, Kitaibaraki Municipal General Hospital, Kitaibaraki, Ibaraki, Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Mashiko
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Masayuki
authors.initials: M
authors.lastname: Sato
authors.forename: Shozo
authors.initials: S
authors.lastname: Noguchi
authors.forename: Akira
authors.initials: A
authors.lastname: Matsumura
mesh_terms: D000368:Aged; D005164:Factor IX / Q000627:therapeutic use; D005169:Factor VIII / Q000235:genetics / Q000627:therapeutic use; D017809:Fatal Outcome; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006408:Hematoma, Subdural / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D006467:Hemophilia A / Q000150:complications* / Q000188:drug therapy / Q000235:genetics; D006801:Humans; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D008297:Male; D011859:Radiography; D013788:Thalamus / Q000098:blood supply / Q000473:pathology; D017211:Treatment Failure
chemical_list: D005169:Factor VIII; D005164:Factor IX