Acquired Hemophilia A in an Elderly Patient Receiving Clopidogrel: Drug-Induced or Age-Associated Autoimmunity?

Abstract

Acquired haemophilia A (AHA) is a rare but potentially life-threatening autoimmune bleeding disorder caused by autoantibodies against factor VIII. Its presentation is often non-specific and can mimic more common causes of bleeding, leading to delayed diagnosis, particularly in elderly patients. We report the case of a 93-year-old man with multiple comorbidities who presented with spontaneous, extensive bruising and haemorrhagic complications. Laboratory evaluation demonstrated findings consistent with AHA, including isolated prolongation of the activated partial thromboplastin time (aPTT), reduced factor VIII activity, and the presence of factor VIII inhibitors. The patient received haematology-directed treatment; however, his clinical course was complicated, and he ultimately died. This case highlights the importance of maintaining a high index of suspicion for AHA in elderly patients presenting with unexplained bleeding and emphasises the need for prompt diagnosis and early multidisciplinary management.