acquired coagulation factor inhibitors

The coagulation studies reveal a normal PT and a prolonged aPTT, which is indicative of an intrinsic pathway disorder and is the typical pattern seen in patients with hemophilia A and B, von Willebrand disease, and certain acquired disorders. Because the X-linked recessive hemophilias are rare in female patients and this woman has no prior history of bleeding suggestive of von Willebrand disease, her bleeding disorder is most likely the result of an acquired coagulation factor inhibitor. Examples of coagulation factor inhibitors include antiphospholipid antibodies (which cause thrombosis) and inhibitors of factors VIII, IX, and XI. Antibodies to factor VIII (''acquired hemophilia'') can result in potentially severe bleeding, and can occur independently or be associated with malignancy, pregnancy, lymphoproliferative disorders, or rheumatic disease.

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