Aspirin unmasking acquired haemophilia A in a patient with prostate cancer.
A 72-year-old man, on treatment for prostate cancer, attended the emergency department with his 2nd episode of spontaneous extensive bruising and haematomas. His first presentation was 2 months prior but this was thought to be because of his aspirin and he improved when aspirin was discontinued. On this occasion aspirin had been restarted 7 days before he developed his symptoms. His blood investigation was significant for a much raised activated partial thromboplastin time (aPTT). On his 3rd day of admission he deteriorated clinically with a drastic drop in his haemoglobin and worsening tense haematomas. Blood investigations confirmed the diagnosis of acquired factor VIII deficiency and he subsequently received treatment with factor VIII inhibitor bypassing activity, steroids and immunosuppresants.
Department of Medicine, Sligo University Hospital, Sligo, Ireland.
Julie Omolola
JO
Okiro
Sligo University Hospital, Sligo, Ireland.
Amjad Zaman
AZ
Khan
Galway University Hospitals, Galway, Galway, Ireland.
Fergus
F
Keane
Mercy University Hospital, Cork, Ireland.
Faiza
F
Murad
D000368:Aged; D001241:Aspirin / Q000009:adverse effects*; D003288:Contusions / Q000139:chemically induced; D006406:Hematoma / Q000139:chemically induced; D006467:Hemophilia A / Q000139:chemically induced / Q000175:diagnosis*; D006801:Humans; D008297:Male; D010314:Partial Thromboplastin Time; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000188:drug therapy*
D010975:Platelet Aggregation Inhibitors; D001241:Aspirin