# An Unusual Cause of Refractory Bleeding in Cirrhosis

## TL;DR

This paper discusses a rare bleeding disorder in a cirrhosis patient, highlighting the challenges of diagnosing it due to overlapping coagulation issues.

## Contribution

The paper presents a rare case of AHA in decompensated cirrhosis, emphasizing diagnostic complexities.

## Key findings

- AHA was identified in a patient with decompensated cirrhosis.
- Abnormal coagulation markers in cirrhosis complicate AHA diagnosis.
- Refractory bleeding occurred due to undiagnosed AHA.

## Abstract

Acquired hemophilia A (AHA) is a rare bleeding disorder caused by the development of antibodies against factor VIII. AHA has previously been reported in association with malignancy and autoimmune disorders, but rarely with liver disease. A prolonged activated partial thromboplastin time is the initial laboratory manifestation of this condition but may be challenging to interpret in the setting of abnormal markers of coagulation typically seen in cirrhosis. We present a case of AHA in a patient with decompensated cirrhosis resulting in refractory bleeding and highlight the complexities of interpreting abnormal coagulation factors in patients with cirrhosis.