title: Acquired factor VIII deficiency presenting with compartment syndrome.
abstract: Acquired factor VIII deficiency is a rare disease that has high rates of mortality and morbidity. Although this bleeding disorder has a classic presentation, its infrequency can make it difficult to identify. We present a case report of an elderly woman who came to an emergency department with spontaneous bilateral lower extremity compartment syndrome. Although she presented with tachycardia and hypotension, her only laboratory abnormalities were an elevated activated partial thromboplastin time and anemia. She underwent bilateral fasciotomies and had a postoperative course that was complicated by significant incisional bleeding. She was ultimately found to have acquired factor VIII deficiency. Emergency physicians must be familiar with this rare entity because its recognition can avoid serious complications, particularly in those requiring operative management.
authors.affiliation: Department of Emergency Medicine, University of Maryland Medical Center, Baltimore, MD.
authors.forename: Thuy V
authors.initials: TV
authors.lastname: Pham
authors.affiliation: Departments of Emergency Medicine and Internal Medicine, University of Maryland Medical Center, Baltimore, MD.
authors.forename: Carina A
authors.initials: CA
authors.lastname: Sorenson
authors.affiliation: Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD. Electronic address: jnable@umem.org.
authors.forename: Jose V
authors.initials: JV
authors.lastname: Nable
mesh_terms: D000368:Aged; D003161:Compartment Syndromes / Q000000981:diagnostic imaging / Q000209:etiology*; D004636:Emergency Service, Hospital; D005260:Female; D006467:Hemophilia A / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007866:Leg / Q000098:blood supply / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed