A Case of Acquired Hemophilia A Complicating Gastric Carcinoma: A Rare Hemorrhagic Condition That Palliative Care Physicians May Encounter

  • Maekawa Kenichi
    Palliative Care Center, Kagoshima University Hospital
  • Ito Tetsuya
    Department of Palliative Care, Japanese Red Cross Medical Center
  • Takei Kiyozumi
    Department of Palliative Care, Japanese Red Cross Medical Center
  • Matoba Motohiro
    Department of Palliative Medicine, Aomori Prefectural Central Hospital

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Other Title
  • 胃がんに合併した後天性血友病Aの1例─緩和ケア医も経験しうる稀な出血性疾患─

Abstract

<p>Abstract: We report a case of acquired hemophilia A diagnosed after hospitalization in a palliative care unit. Case: The patient was an 86-year-old man diagnosed with gastric carcinoma one-year prior, who declined treatment but whose progress was being monitored. He was admitted to our hospital due to multiple, systemic, and subcutaneous bleeding and exacerbation of anemia. Blood testing revealed prolonged activated partial thromboplastin time (APTT), but the cause was unknown. Subcutaneous bleeding persisted after hospitalization, accompanied by pain. After admission to a palliative care unit, blood testing revealed only prolonged APTT; hence, a coagulation study was performed, resulting in a diagnosis of acquired hemophilia A. Immunosuppressive therapy was considered but was not performed as the patient’s progress was complicated by aspiration pneumonia for which antibiotics were ineffective, and the patient’s prognosis was determined to be short. The patient died on the 20th day after admission to the palliative care unit. Conclusion: Acquired hemophilia A is a rare hemorrhagic condition, but it is important to suspect it in cases involving prolonged APTT and spontaneous bleeding with no medical history or family history.</p>

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