A large spontaneous abdominal bruise in a 60-year-old woman: a case report.
OBJECTIVE
To report a case of severe abdominal bruising successfully diagnosed using systematic hemostatic investigations.


METHODS
A 60-year-old woman developed a large spontaneous nontraumatic, painless bruise over the right lower abdominal wall. Computed tomographic scan of the abdomen showed a subcutaneous hematoma beneath the site of the obvious bruise diagnosed as a hematoma. Laboratory tests revealed an activated partial thromboplastin time of 53 s and a factor VIII level of <1%, consistent with the diagnosis of acquired hemophilia A. The patient was treated with steroids and immunosuppressants and her factor VIII levels gradually normalized.


CONCLUSIONS
This case report showed that whenever there is spontaneous bruising, factor VIII deficiency should be considered as one of the important differential diagnosis.
Department of Medicine, Unity Health System, 1555 Long Pond Rd., Rochester, NY 14626, USA. smogili@unityhealth.org
Sujatha
S
Mogili
Timothy
T
Woodlock
D000005:Abdomen / Q000473:pathology*; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D003288:Contusions / Q000175:diagnosis* / Q000473:pathology; D005169:Factor VIII; D005260:Female; D006406:Hematoma / Q000175:diagnosis* / Q000473:pathology; D006467:Hemophilia A / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D013997:Time Factors
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D005169:Factor VIII