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Case Reports in Hematology
Volume 2013, Article ID 521785, 3 pages
http://dx.doi.org/10.1155/2013/521785
Case Report

An Unusual Etiology for Elevation of Activated Partial Thromboplastin Time (aPTT) in SLE: Acquired Hemophilia and Lupus Anticoagulant

Department of Internal Medicine, University of New Mexico, Albuquerque, NM 87131, USA

Received 7 July 2013; Accepted 5 September 2013

Academic Editors: S. Davidson, H. Guglielmone, K. Khair, and M. Singh

Copyright © 2013 Srikanth Seethala et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 60-year-old female who has a history significant for diabetes, depression, and rheumatoid arthritis presented with a progressively enlarging hematoma of the left upper extremity. She was found to have an enlarging hematoma and an isolated elevation of activated partial thromboplastin time (aPTT). Lab work-up revealed low factor VIII activity levels and inhibitor titers at 13.38 Bethesda units (BU). Dilute Russell’s viper venom time (dRVVT) revealed a lupus anticoagulant. Hemostasis was achieved with factor VIII inhibitor bypassing activity (FEIBA) and inhibitor eradication with-rituxan after the failure of first-line treatment with cyclophosphamide and prednisone.