BACKGROUND Acquired haemophilia(AH)is a serious autoimmune haematological disease caused by the production of auto-antibodies against coagulation factor VIII.In some patients,AH is associated with a concomitant malign...BACKGROUND Acquired haemophilia(AH)is a serious autoimmune haematological disease caused by the production of auto-antibodies against coagulation factor VIII.In some patients,AH is associated with a concomitant malignancy.In case of surgical intervention,AH poses a high risk of life-threatening bleeding.CASE SUMMARY A 60-year-old female patient with multiple recurrences of non-muscle invasive bladder cancer underwent transurethral tumour resection.A severe haematuria developed postoperatively warranting two endoscopic revisions;however,no clear source of bleeding was identified in the bladder.Subsequent haematological examination established a diagnosis of AH.Treatment with factor VIII inhibitor bypass activity and immunosuppressive therapy was initiated immediately.The patient responded well to the therapy and was discharged from the hospital 21 d after the primary surgery.At the 38-mo follow-up,both AH and bladder cancer remained in complete remission.CONCLUSION AH is a rare,life-threatening haematological disease.AH should be considered in patients with persistent severe haematuria or other bleeding symptoms,especially if combined with isolated activated partial thromboplastin time prolongation.展开更多
基金Supported by conceptual development of research organization,Ministry of Health,Czech Republic,No.FNOs/2023.
文摘BACKGROUND Acquired haemophilia(AH)is a serious autoimmune haematological disease caused by the production of auto-antibodies against coagulation factor VIII.In some patients,AH is associated with a concomitant malignancy.In case of surgical intervention,AH poses a high risk of life-threatening bleeding.CASE SUMMARY A 60-year-old female patient with multiple recurrences of non-muscle invasive bladder cancer underwent transurethral tumour resection.A severe haematuria developed postoperatively warranting two endoscopic revisions;however,no clear source of bleeding was identified in the bladder.Subsequent haematological examination established a diagnosis of AH.Treatment with factor VIII inhibitor bypass activity and immunosuppressive therapy was initiated immediately.The patient responded well to the therapy and was discharged from the hospital 21 d after the primary surgery.At the 38-mo follow-up,both AH and bladder cancer remained in complete remission.CONCLUSION AH is a rare,life-threatening haematological disease.AH should be considered in patients with persistent severe haematuria or other bleeding symptoms,especially if combined with isolated activated partial thromboplastin time prolongation.