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Acquired hemophilia A — RCPSC IM MCQ

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HardHematologyAcquired hemophilia ARCPSC IM

A 77-year-old man has extensive spontaneous bruising and soft-tissue bleeding. Platelets are normal, INR is normal and aPTT is 86 seconds. Mixing study fails to correct after incubation. Factor VIII activity is very low and Bethesda assay is positive. What is the most likely diagnosis?

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Correct answer: C — Acquired hemophilia A

Isolated prolonged aPTT, failure to correct on incubated mixing study and low factor VIII with inhibitor confirm acquired hemophilia A.

Reference: Canadian hematology bleeding disorder guidance