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Patients with new onset bleeding and a prolonged activated partial thromboplastin time (aPTT) may have an acquired factor VIII inhibitor, especially if they are elderly, have malignancy or autoimmune disease, or are pregnant. Although rare, the diagnosis is important to establish because bleeding occurs in 90% of patients and often involves subcutaneous, muscular, gastrointestinal, genitourinary, or retroperitoneal sites. Now, an international panel of experts has updated 2009 guidelines regarding the diagnosis and management of patients with acquired factor VIII inhibitors.
The diagnosis of acquired factor VIII inhibitor should be considered in patients with acute bleeding and unexplained prolo…