title: A patient with acquired hemophilia A induced by clopidogrel.
abstract: Acquired hemophilia A (AHA) is a rare bleeding disorder caused by autoantibodies against factor VIII (FVIII). Treatment with clopidogrel is a cause of AHA, but its clinical course is unknown. Recently, we treated a 65-year-old man who was hospitalized for cerebellar infarction and had a prolonged activated partial thromboplastin time (aPTT) with soft tissue oozing after 3 weeks of clopidogrel use. We terminated clopidogrel administration and transfused the patient with fresh frozen plasma. However, the aPTT increased up to 98.8 seconds, and the FVIII and FVIII inhibitor levels were <1% and 5.4 Bethesda units/mL, respectively. Clopidogrel-associated AHA was considered, and we began steroid treatment. Two months later, FVIII, FVIII inhibitor, and aPTT values were normalized. No further bleeding or aPTT prolongation has been reported during the 2-year follow-up period. AHA should be considered in patients taking clopidogrel and experiencing bleeding, unless the platelet count and coagulation screen are normal.
authors.affiliation: Division of Hematology-Oncology, Department of Medicine, Wonju Christian Hospital, Yonsei University College of Medicine, Wonju, Korea.
authors.forename: Hye Won
authors.initials: HW
authors.lastname: Hwang
authors.forename: Jee Hyun
authors.initials: JH
authors.lastname: Kong
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Yu
authors.forename: Woo Taek
authors.initials: WT
authors.lastname: Kim
authors.forename: Hyun Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Chong In
authors.initials: CI
authors.lastname: Lee