Case Presentation: A 73  year old female with borderline diabetes mellitus and hypertension presented to the emergency department with the sudden onset of nontraumatic swelling, pain and ecchymosis of her right leg. She did report receiving an influenza vaccination at her left arm 3 weeks prior to this visit resulting in bruising from her shoulder [...]

Case Presentation: Acquired Hemophilia A (AHA) is a rare disease, with 1 to 2 cases per million, and occurs due to production of autoantibodies that inhibit Factor VIII, a vital step of the intrinsic coagulation cascade, resulting in the potential for lethal bleeding. Here we present a case of a 59-year-old woman with history of [...]

Case Presentation: Acquired hemophilia A is a rare disorder related to autoantibodies against factor VIII (Fc VIII) and reduced Fc VIII/VIII inhibitors causing bleeding. The incidence is 1 to 1.5 per million a year with 78 years as a median. Diagnosis is crucial due to the mortality can include spontaneous hemorrhages into skin, muscles, soft [...]

Case Presentation: A 68 year old male with a history of severe hemophilia (factor VIII <1%) and hypertension presented with symptoms of nausea, vomiting, severe dyspnea, diaphoresis and substernal chest pain for several days prior to admission. On initial presentation, electrocardiogram revealed ST-segment depressions in leads V5 and V6, with a troponin elevation to 24, [...]

Case Presentation: A 77-year-old woman presented with altered mental status, tachycardia, tachypnea, and hypotension. Her family noted 1 month of progressive lethargy, with spontaneous subconjunctival hemorrhage and various episodes of facial and extremity bruising (for which she had 3 prior ED visits). Past medical history was notable for hypertension, remote history of nosebleeds, and menorrhagia [...]

Case Presentation: We present a case of acquired hemophilia A (AHA) in an elderly patient with longstanding rheumatoid arthritis (RA). An 85-year-old woman was transferred from an outside hospital for further evaluation of spontaneous soft tissue hematomas. She reported numerous enlarged bruises, spontaneously appearing on her upper and lower extremities over the last 2 months. [...]

Case Presentation: A 74 year old male with a history of atrial fibrillation on rivaroxaban was admitted to an outside hospital with a spontaneous right gluteus medius and piriformis intramuscular hematoma measuring 5.8 cm found on computerized tomography (CT). On admission, he had a hemoglobin of 7.7 gm/dL, an elevated activated partial thromboplastin time not [...]

Case Presentation: 82-year-old man on chronic Warfarin presented for evaluation of spontaneous right lower extremity swelling with bruising. Workup showed hemoglobin of 9.5 g/dL, platelet of 286 K/µL, PT 47.4 seconds, INR 5.0, and PTT > 200 seconds. CT of abdomen and leg revealed intra-abdominal hemorrhage and subcutaneous hematoma of the right leg. Within the [...]

Case Presentation: A 70-year-old African American woman with a past medical history of hypertension, Type II diabetes mellitus, and COPD presented to the emergency department complaining of new-onset right arm bruising and swelling with no history of trauma. The patient had been recently hospitalized a week prior for a chest pain workup that was negative. [...]

Case Presentation: A 93-year-old female with a history of stroke, hypertension, moderate aortic stenosis (AS) and peripheral vascular disease presented with four days of right lower extremity pain. She had recently been seen in vascular clinic for difficulty walking and associated pain, which was attributed to chronic venous insufficiency. In the emergency department, examination revealed [...]