Management of Acquired Hemophilia a in the Backdrop of Coronavirus Disease 19 and Multiple Myeloma

Background Acquired hemophilia A (AHA) is an autoimmune disorder characterized by unexpected bleeding that is likely caused by the development of clotting factor VIII inhibitors. Both virus infections and hematologic malignancies are among the possible underlying conditions for AHA because of their potential to cause immune dysfunction. Currently, the main treatments for AHA focus on achieving hemostasis and removing inhibitors, as well as managing the underlying pathology.

Case presentation Herein we present a patient who was diagnosed with AHA complicated with an emergency of osteofascial compartment syndrome. The patient experienced acute subcutaneous bleeding in his left calf during his recovery from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Notably, the patient also had multiple myeloma (MM) and was undergoing maintenance treatment. Cases of coronavirus disease 19 (COVID-19) or MM-associated AHA are rare, and there have been no reported AHA cases with both underlying conditions. To determine the potential causes of AHA, a comprehensive analysis was conducted. Hemostatic and immunosuppressive treatments were administered based on the underlying etiology and relevant examination findings, ultimately resulting in a successful cure for AHA.

ConclusionThis clinical case highlights the occurrence of severe bleeding in an MM patient who was undergoing maintenance therapy and contracted SARS-CoV-2 infection. The patient was subsequently diagnosed with AHA. Given the presence of multiple immune disorder factors, clinicians should carefully analyze the potential contributing factors to guide treatment decisions and prevent future recurrences.

No relevant conflicts of interest to declare.