Acquired hemophilia A following COVID-19 vaccination – The importance of prompt diagnosis: A case report. (April 2023)

• Record Type: Journal Article
• Authors: Duminuco, Andrea; Calagna, Marianna; Markovic, Uros; Esposito, Benedetta; Grasso, Stephanie; Riccobene, Carla; Di Raimondo, Francesco; Giuffrida, Gaetano
• Is Part Of: Transfusion and apheresis science. Volume 62:Number 2(2023)
• Publication Date: 2023-04
• Subjects: Acquired Hemophilia A -- COVID-19 -- Vaccination -- Bleeding disorders -- AHA diagnostic work-up; Blood -- Transfusion -- Periodicals; Hemapheresis -- Periodicals; 615.39
• DOI: 10.1016/j.transci.2022.103577
• Languages: English
• ISSNs: 1473-0502

Abstract

Abstract: Acquired hemophilia A (AHA) is a rare coagulopathy characterized by hemorrhagic manifestations. It has been linked to various conditions, including autoimmune disorders, drugs, tumors, lymphoproliferative disorders, and infections. We present a case of AHA in a 71-year-old male patient with cutaneous hematoma occurring 8 days after vaccination for COVID-19. This report aims to highlight the risk of FVIII inhibitor development following an immune stimulus, thus improving our knowledge regarding possible vaccination-related adverse events. Furthermore, we underline how the potential risk of not recognizing disease manifestations promptly, together with specific coagulation alterations, could significantly affect the patient's outcome. Adequate management plans and the diffusion of shared guidelines are of fundamental importance in order to prevent the development of life-threatening complications and initiate appropriate treatment as soon as possible. Data Availability: All data generated or analyzed during this study are included in this article. Further inquiries can be directed to the corresponding author. Highlights: Acquired hemophilia A (AHA) is a rare coagulopathy characterized by hemorrhagic manifestations. Vaccination may trigger an autoimmune response leading to disorders (e.g., AHA). An easily shared diagnostic algorithm for AHA should be shared. A shared multidisciplinary path is necessary to guarantee the best care.