Abstract：
Acquired haemophilia A (AHA) is a rare bleeding disorder with high morbidity and mortality, but it is eminently treatable if diagnosis and treatment are prompt. We report a case of AHA in Southeast Asia following the administration of the Pfizer-BioNTech COVID-19 vaccine. A man in his 80s developed multiple bruises 2 weeks after his first dose of the COVID-19 vaccine. Diagnosis was delayed due to his cognitive impairment and low clinical suspicion. This led to a representation with worsening ecchymosis, a left thigh haematoma and symptomatic anaemia. Laboratory testing was notable for an isolated prolongation of the activated partial thromboplastin time, which remained uncorrected in the mixing test. Further testing confirmed the presence of factor VIII (FVIII) inhibitors and low FVIII titres of 6.7%. He responded to treatment with intravenous methylprednisolone and recombinant activated FVII. Screening for autoimmune diseases and malignancies was negative.
摘要：
获得性血友病A（AHA）是一种罕见的出血性疾病，具有很高的发病率和死亡率，但如果及时诊断和治疗，它是可以治疗的。我们报告了在使用辉瑞-BioNTechCOVID-19疫苗后在东南亚发生的一例AHA。一名80多岁的男子在第一次接种新冠肺炎疫苗两周后出现多处瘀伤。由于他的认知障碍和低临床怀疑，诊断被推迟。这导致瘀斑恶化，左大腿血肿和有症状的贫血。实验室测试值得注意的是激活的部分凝血活酶时间的单独延长，在混合试验中仍未校正。进一步的测试证实了因子VIII(FVIII)抑制剂的存在和6.7%的低FVIII滴度。他对静脉注射甲基强的松龙和重组活化FVII的治疗有反应。自身免疫性疾病和恶性肿瘤筛查阴性。
