Acquired haemophilia A diagnosed during preoperative evaluation for lung cancer surgery: A case report.
Ana Tobaruela, Teresa López, José A Sastre
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Case in brief
During preoperative assessment for lung tumour resection, a patient was found to have a prolonged activated partial thromboplastin time. Further testing showed reduced factor VIII activity and detectable factor VIII inhibitors, establishing acquired haemophilia A. Oral prednisone was followed by normalisation of coagulation parameters and disappearance of the inhibitors within 4 weeks. The lung tumour was then resected without haemorrhagic complications.
What made this case unusual
The disorder was detected during preoperative evaluation in a patient without a reported bleeding presentation, before planned thoracic surgery.
Diagnostic / clinical pearl
An unexplained prolonged aPTT before surgery warrants evaluation for acquired haemophilia A, including factor VIII activity and inhibitor testing, because the diagnosis can affect perioperative bleeding risk.
Why it matters
The report illustrates that identifying and treating the coagulation disorder before thoracic surgery may allow resection without haemorrhagic complications.