Bleeding Mystery Unveiled: A Case of Acquired Hemophilia A in the Shadow of Multiple Myeloma

TL;DR

A woman initially thought to have von Willebrand disease was found to have multiple myeloma, which caused a rare bleeding disorder.

Contribution

Highlights a rare case linking multiple myeloma to acquired factor VIII deficiency mistaken for von Willebrand disease.

Findings

A patient with recurrent bleeding was diagnosed with multiple myeloma after initial von Willebrand disease suspicion.

Factor VIII levels normalized after stem cell transplantation, indicating autoimmune-induced deficiency.

The case underscores the need to consider secondary causes in bleeding disorders.

Abstract

This case report is of a 50-year-old woman who had a working diagnosis of von Willebrand disease (vWD) due to a history of bleeding complications and continued to experience recurrent bleeding incidents and hematoma. A workup revealed multiple lytic lesions, and a bone marrow biopsy yielded the diagnosis of multiple myeloma. After stem cell transplantation, the patient's factor VIII levels normalized, supporting acquired factor VIII deficiency due to an autoimmune phenomenon. This case highlights the rare occurrence of acquired factor VIII deficiency secondary to multiple myeloma. It also emphasizes the importance of considering secondary causes in patients with a working diagnosis of vWD and recurrent bleeding incidents.

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