What to know about acquired hemophilia

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Acquired hemophilia describes an uncommon blood disorder and autoimmune condition that can lead to excessive internal and external bleeding. This is due to the body being unable to form blood clots correctly. This can occur spontaneously or following surgery or an injury.

An autoimmune condition is when the body produces antibodies that mistakenly attack healthy cells in the body. Acquired hemophilia occurs when the body produces antibodies that attack proteins, or coagulation factors, in the blood that help clots form.

This results in the blood no longer clotting properly. This can lead to excessive bleeding, which can present in the form of:

• nosebleeds
• internal bruising
• solid masses of clotted blood
• blood in the urine
• bleeding in the digestive system
• blood in the genital organs

A person with hemophilia will typically have low levels of blood clotting factors, such as factor VIII or factor IX, in the blood. Low levels of these proteins may prevent blood clots from forming, which can lead to spontaneous bleeding.

Hereditary hemophilia is when a person inherits alterations of the genes responsible for producing these blood clotting factors. These gene variations do not typically produce enough blood clotting proteins to form blood clots. Some types of hereditary hemophilia include:

• hemophilia A
• hemophilia B
• hemophilia C

Acquired hemophilia can occur when the body produces antibodies that attack the blood-clotting proteins. Therefore, the body does not produce enough protein to form blood clots.

Hereditary hemophilia is more likely to affect males than females due to the type of chromosomes a male person is born with. Evidence suggests that hereditary hemophilia affects approximately 20,000–33,000 men in the United States.

According to research, acquired hemophilia may affect males and females equally.

A person with hereditary hemophilia is typically born with the condition. However, acquired hemophilia usually develops as a person gets older. A 2022 article refers to a study from 2015, which suggests that 80% of people with acquired hemophilia are over the age of 80 years.

Acquired hemophilia is less common than hereditary hemophilia and can be more difficult to diagnose.

Read on to learn more about the inheritance pattern of hereditary hemophilia.

The most common symptom of acquired hemophilia is bruising underneath the skin. Other symptoms can include:

• nose bleeds
• bleeding after vaccinations
• bleeding in the mouth and gums
• bleeding in the muscles
• bleeding in the digestive organs
• bleeding in the urinary and genital organs
• bleeding in the brain
• blood in urine or stool
• heavy genital bleeding after giving birth

Research suggests that in approximately 50% of people with acquired hemophilia, there are no identifiable causes. In the other 50%, causes and risk factors of acquired hemophilia can include:

• an underlying autoimmune condition such as lupus, rheumatoid arthritis, and multiple sclerosis
• health conditions such as inflammatory bowel disease, diabetes, and hepatitis
• contracting an infection
• blood cancer or some cancerous tumors
• reactions to medications such as penicillin and interferon
• pregnancy or giving birth

To diagnose acquired hemophilia, a doctor may take a full medical history and perform a physical examination.

If symptoms of acquired hemophilia, such as bruising, are present, a doctor may take a blood sample to test if the blood is clotting correctly.

Further laboratory tests can determine if a person has issues with their blood clotting proteins and if the antibodies attacking those proteins are present. If this is the case, a doctor may confirm a diagnosis of acquired hemophilia.

Acquired hemophilia is a rare condition that affects approximately 1.5 in every million people annually. Therefore, treatment may be different for each person.

Some common treatments can include:

• treating any underlying health conditions
• anti-hemorrhagic medications to control bleeding, such as bypassing agents
• immunosuppression therapy, such as corticosteroids

Acquired hemophilia is a serious condition. Approximately 70% of people with acquired hemophilia may experience severe bleeding.

Research suggests that acquired hemophilia can lead to fatality in approximately 8%–22% of people with the condition. However, these survival rates may increase if a person is receiving anti-hemorrhagic treatments.

Survival rate may decrease if a person does not receive appropriate treatment, receives a late diagnosis, or experiences severe bleeding during a surgical procedure.

Acquired hemophilia is a rare bleeding disorder and autoimmune condition that can cause spontaneous bleeding. This is due to antibodies mistakenly attacking certain proteins in the body that stop the blood from clotting correctly.

When the blood does not clot correctly, it can lead to sudden and prolonged internal and external bleeding, such as nose bleeds, bruising under the skin, and bleeding in various organs. A person with acquired hemophilia may also experience severe bleeding following an injury or during a surgical procedure.

Hereditary hemophilia can occur when a person inherits certain gene alterations from their parents. Acquired hemophilia can occur when a health condition causes the body to produce certain antibodies that attack clotting factors.