Acquired hemophilia A with sigmoid colon cancer: Successful treatment with rituximab followed by sigmoidectomy

Satoshi Ichikawa, Katsura Kohata, Yoko Okitsu, Makiko Suzuki, Shinji Nakajima, Minami F. Yamada, Yasushi Onishi, Joji Yamamoto, Sozo Suzuki, Kenichi Ishizawa, Junichi Kameoka, Hideo Harigae

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23 Citations (Scopus)


Acquired hemophilia A is a rare and potentially fatal condition of coagulopathy caused by autoantibodies against clotting factor VIII (factor VIII inhibitor). We report a case of a 63-year-old woman, who presented with a sudden onset of severe hemorrhagic tendency with exclusively prolonged activated partial thromboplastin time (APTT). She was diagnosed with acquired hemophilia A due to a decrease in factor VIII activity and a high titer of factor VIII inhibitor. Hemorrhage was well controlled by recombinant activated factor VII. Although the level of factor VIII inhibitor did not decline with prednisolone and cyclophosphamide, it became undetectable with rituximab. In parallel with controlling hemorrhage, malignancy, which may cause acquired hemophilia A, was searched for and sigmoid colon cancer was found. After the eradication of factor VIII inhibitor, surgical resection was performed uneventfully. Thereafter, acquired hemophilia A has been in complete remission without any additional therapy. The present case suggests the efficacy of rituximab for refractory acquired hemophilia A and the importance of the identification of underlying diseases that can cause acquired hemophilia A.

Original languageEnglish
Pages (from-to)33-36
Number of pages4
JournalInternational Journal of Hematology
Issue number1
Publication statusPublished - 2009 Jul


  • Acquired hemophilia A
  • Colon cancer
  • Rituximab


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