Table of Contents Author Guidelines Submit a Manuscript
Case Reports in Hematology
Volume 2013, Article ID 628513, 7 pages
http://dx.doi.org/10.1155/2013/628513
Case Report

An Acquired Factor VIII Inhibitor in a Patient with HIV and HCV: A Case Presentation and Literature Review

1Department of Internal Medicine, Mount Sinai Medical Center, Miami Beach, FL 33140, USA
2Department of Radiology, Mount Sinai Medical Center, Miami Beach, FL 33140, USA
3Division of Hematology/Oncology, Mount Sinai Medical Center, Miami Beach, FL 33140, USA

Received 26 July 2013; Accepted 29 August 2013

Academic Editors: R. Herrmann, K. Khair, M.-C. Kyrtsonis, and Y. Matsukawa

Copyright © 2013 S. B. Zeichner 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

Introduction. Despite its low incidence, acquired factor VIII inhibitor is the most common autoantibody affecting the clotting cascade. The exact mechanism of acquisition remains unclear, but postpartum patients, those with autoimmune conditions or malignancies, and those with exposure to particular drugs appear most susceptible. There have been several case reports describing acquired FVIII inhibitors in patients receiving interferon alpha for HCV treatment and in patients being treated for HIV. To our knowledge, this is the first case of a patient with HCV and HIV who was not actively receiving treatment for either condition. Case Presentation. A 57-year-old Caucasian male with a history of HIV and HCV was admitted to our hospital for a several day history of progressively worsening right thigh bruising and generalized weakness. CTA of the abdominal arteries revealed large bilateral retroperitoneal hematomas. Laboratory studies revealed the presence of a high titer FVIII inhibitor. Conclusion. Our case of a very rare condition highlights the importance of recognizing and understanding the diagnosis of acquired FVIII inhibitor. Laboratory research and clinical data on the role of newer agents are needed in order to better characterize disease pathogenesis, disease associations, genetic markers, and optimal disease management.